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Homework answers / question archive / Chapter 34: Personality Disorders Multiple Choice Identify the choice that best completes the statement or answers the question
Chapter 34: Personality Disorders
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1) During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the most appropriate nursing statement to address this behavior?
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A. |
“You are very disrespectful. You need to learn to control yourself.” |
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B. |
“I understand that you are angry, but this behavior will not be tolerated.” |
|
C. |
“What behaviors could you modify to improve this situation?” |
|
D. |
“What anti-personality-disorder medications have helped you in the past?” |
____ 2. A client diagnosed with antisocial personality disorder comes to a nurses’ station at 11:00 p.m. requesting to phone a lawyer to discuss filing for a divorce. The unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing reply is most appropriate?
|
A. |
“Go ahead and use the phone. I know this pending divorce is stressful.” |
|
B. |
“You know better than to break the rules. I’m surprised at you.” |
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C. |
“It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow.” |
|
D. |
“The decision to divorce should not be considered until you have had a good night’s sleep.” |
____ 3. A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate?
|
A. |
Provide objective evidence, that violence is unwarranted. |
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B. |
Initially restrain the client to maintain safety. |
|
C. |
Use clear, calm statements and a confident physical stance. |
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D. |
Empathize with the client’s paranoid perceptions. |
____ 4. A highly emotional client presents at an outpatient clinic appointment wearing flamboyant attire, spiked heels, and theatrical makeup. Which personality disorder should a nurse associate with this assessment data?
|
A. |
Compulsive personality disorder |
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B. |
Schizotypal personality disorder |
|
C. |
Histrionic personality disorder |
|
D. |
Manic personality disorder |
____ 5. A client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. How can the nursing staff best handle this situation?
|
A. |
Allow the clients to apply the democratic process when developing unit rules. |
|
B. |
Maintain consistency of care by open communication to avoid staff manipulation. |
|
C. |
Allow the client spokesman to verbalize concerns during a unit staff meeting. |
|
D. |
Maintain unit order by the application of autocratic leadership. |
____ 6. Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder?
|
A. |
Being firm, consistent, and empathic, while addressing specific client behaviors |
|
B. |
Promoting client self-expression by implementing laissez-faire leadership |
|
C. |
Using authoritative leadership to help clients learn to conform to society norms |
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D. |
Overlooking inappropriate behaviors to avoid promoting secondary gains |
____ 7. Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality disorder?
|
A. |
A physically healthy client who is dependent on meeting social needs by contact with 15 cats |
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B. |
A physically healthy client who has a history of depending on intense relationships to meet basic needs |
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C. |
A physically healthy client who lives with parents and relies on public transportation |
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D. |
A physically healthy client who is serious, inflexible, perfectionistic, and depends on rules to provide security |
____ 8. A pessimistic client expresses low self-worth, has much difficulty making decisions, avoids positions of responsibility, and has a behavioral pattern of “suffering” in silence. Which underlying cause of this client’s personality disorder should a nurse recognize?
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A. |
“Nurturance was provided from many sources, and independent behaviors were encouraged.” |
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B. |
“Nurturance was provided exclusively from one source, and independent behaviors were discouraged.” |
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C. |
“Nurturance was provided exclusively from one source, and independent behaviors were encouraged.” |
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D. |
“Nurturance was provided from many sources, and independent behaviors were discouraged.” |
____ 9. Family members of a client ask a nurse to explain the difference between schizoid and avoidant personality disorders. Which is the appropriate nursing reply?
|
A. |
“Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed with schizoid personality disorder prefer to be alone.” |
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B. |
“Clients diagnosed with schizoid personality disorder exhibit odd, bizarre, and eccentric behavior, while clients diagnosed with avoidant personality disorder do not.” |
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C. |
“Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with schizoid personality disorder are dull and vacant.” |
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D. |
“Clients diagnosed with schizoid personality disorder have a history of psychotic thought processes, while clients diagnosed with avoidant personality disorder remain based in reality.” |
____ 10. During an interview, which client statement indicates to a nurse that a potential diagnosis of schizotypal personality disorder should be considered?
|
A. |
“I really don’t have a problem. My family is inflexible, and every relative is out to get me.” |
|
B. |
“I am so excited about working with you. Have you noticed my new nail polish: ‘Ruby Red Roses’?” |
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C. |
“I spend all my time tending my bees. I know a whole lot of information about bees.” |
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D. |
“I am getting a message from the beyond that we have been involved with each other in a previous life.” |
____ 11. A nursing instructor is teaching students about clients diagnosed with histrionic personality disorder and the quality of their relationships. Which student statement indicates that learning has occurred?
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A. |
“Their dramatic style tends to make their interpersonal relationships quite interesting and fulfilling.” |
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B. |
“Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs.” |
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C. |
“They tend to develop few relationships because they are strongly independent but generally maintain deep affection.” |
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D. |
“They pay particular attention to details which can frustrate the development of relationships.” |
____ 12. Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder?
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A. |
Altered thought processes R/T increased stress |
|
B. |
Risk for suicide R/T loneliness |
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C. |
Risk for violence: directed toward others R/T paranoid thinking |
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D. |
Social isolation R/T inability to relate to others |
____ 13. When planning care for a client diagnosed with borderline personality disorder, which self-harm behavior should a nurse expect the client to exhibit?
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A. |
The use of highly lethal methods to commit suicide |
|
B. |
The use of suicidal gestures to evoke a rescue response from others |
|
C. |
The use of isolation and starvation as suicidal methods |
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D. |
The use of self-mutilation to decrease endorphins in the body |
____ 14. Which client situation should a nurse identify as reflective of the impulsive behavior that is commonly associated with borderline personality disorder?
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A. |
As the day shift nurse leaves the unit, the client suddenly hugs the nurse’s arm and whispers, “The night nurse is evil. You have to stay.” |
|
B. |
As the day shift nurse leaves the unit, the client suddenly hugs the nurse’s arm and states, “I will be up all night if you don’t stay with me.” |
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C. |
As the day shift nurse leaves the unit, the client suddenly hugs the nurse’s arm, yelling, “Please don’t go! I can’t sleep without you being here.” |
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D. |
As the day shift nurse leaves the unit, the client suddenly shows the nurse a bloody arm and states, “I cut myself because you are leaving me.” |
____ 15. Which nursing diagnosis should be prioritized when providing care to a client diagnosed with paranoid personality disorder?
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A. |
Risk for violence: directed toward others R/T suspicious thoughts |
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B. |
Risk for suicide R/T altered thought |
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C. |
Altered sensory perception R/T increased levels of anxiety |
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D. |
Social isolation R/T inability to relate to others |
____ 16. From a behavioral perspective, which nursing intervention is most appropriate when caring for a client diagnosed with borderline personality disorder?
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A. |
Seclude the client when inappropriate behaviors are exhibited. |
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B. |
Contract with the client to reinforce positive behaviors with unit privileges. |
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C. |
Teach the purpose of antianxiety medications to improve medication compliance. |
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D. |
Encourage the client to journal feelings to improve awareness of abandonment issues. |
____ 17. A nurse tells a client that the nursing staff will start alternating weekend shifts. Which response should a nurse identify as characteristic of clients diagnosed with obsessive-compulsive personality disorder?
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A. |
“You really don’t have to go by that schedule. I’d just stay home sick.” |
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B. |
“There has got to be a hidden agenda behind this schedule change.” |
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C. |
“Who do you think you are? I expect to interact with the same nurse every Saturday.” |
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D. |
“You can’t make these kinds of changes! Isn’t there a rule that governs this decision?” |
____ 18. Looking at a slightly bleeding paper cut, the client screams, “Somebody help me, quick! I’m bleeding. Call 911!” A nurse should identify this behavior as characteristic of which personality disorder?
|
A. |
Schizoid personality disorder |
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B. |
Obsessive-compulsive personality disorder |
|
C. |
Histrionic personality disorder |
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D. |
Paranoid personality disorder |
____ 19. Which reaction to a compliment from another client should a nurse identify as a typical response from a client diagnosed with avoidant personality disorder?
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A. |
Interpreting the compliment as a secret code used to increase personal power |
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B. |
Feeling the compliment was well deserved |
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C. |
Being grateful for the compliment but fearing later rejection and humiliation |
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D. |
Wondering what deep meaning and purpose are attached to the compliment |
____ 20. Which client symptoms should lead a nurse to suspect a diagnosis of obsessive-compulsive personality disorder?
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A. |
The client experiences unwanted, intrusive, and persistent thoughts. |
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B. |
The client experiences unwanted, repetitive behavior patterns. |
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C. |
The client experiences inflexibility and lack of spontaneity when dealing with others. |
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D. |
The client experiences obsessive thoughts that are externally imposed. |
____ 21. Which client is a nurse most likely to admit to an inpatient facility for self-destructive behaviors?
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A. |
A client diagnosed with antisocial personality disorder |
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B. |
A client diagnosed with borderline personality disorder |
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C. |
A client diagnosed with schizoid personality disorder |
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D. |
A client diagnosed with paranoid personality disorder |
____ 22. When planning care for clients diagnosed with personality disorders, what should be the anticipated treatment outcome?
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A. |
To stabilize pathology with the correct combination of medications |
|
B. |
To change the characteristics of the dysfunctional personality |
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C. |
To reduce inflexibility of personality traits that interfere with functioning and relationships |
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D. |
To decrease the prevalence of neurotransmitters at receptor sites |
____ 23. The nurse plans to confront a client about secondary gains related to extreme dependency on spouse. Which nursing statement would be most appropriate?
|
A. |
“Do you believe dependency issues have been a lifelong concern for you?” |
|
B. |
“Have you noticed any anxiety during times when your husband makes decisions.” |
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C. |
“What do you know about individuals who depend on others for direction?” |
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D. |
“How have the specifics of your relationship with your spouse benefited you?” |
____ 24. The nurse should recognize which factors that distinguish personality disorders from psychosis?
|
A. |
Functioning is more limited in personality disorders than in psychosis. |
|
B. |
Major disturbances of thought are absent in personality disorders. |
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C. |
Personality disordered clients require hospitalization more frequently. |
|
D. |
Personality disorders do not affect family relationships as much as psychosis. |
____ 25. Which client statement would demonstrate a common characteristic of Cluster “B” personality disorder?
|
A. |
“I wish someone would make that decision for me.” |
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B. |
“I built this building by using materials from outer space.” |
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C. |
“I’m afraid to go to group because it is crowded with people.” |
|
D. |
“I didn’t have the money for the ring, so I just took it.” |
____ 26. When a client on an acute care psychiatric unit demonstrates behaviors and verbalizations indicating a lack of guilt feelings, which nursing intervention would help the client to meet desired outcomes?
|
A. |
Provide external limits on client behavior. |
|
B. |
Foster discussions of rationales for behavioral change. |
|
C. |
Implement interventions consistently by only one staff member. |
|
D. |
Encourage the client to involve self in care. |
____ 27. Which characteristics should a nurse recognize as being exhibited by individuals diagnosed with any personality disorders?
|
A. |
These clients accept and are comfortable with their altered behaviors. |
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B. |
These clients understand that their altered behaviors result from anxiety. |
|
C. |
These clients seek treatment to avoid interpersonal discomfort. |
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D. |
These clients avoid relationships due to past negative experiences. |
____ 28. A nurse would expect a client diagnosed with schizotypal personality disorder to exhibit which characteristic?
|
A. |
The client keeps to self and has few, if any relationships. |
|
B. |
The client has many brief but intense relationships. |
|
C. |
The client experiences incorrect interpretations of external events. |
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D. |
The client exhibits lack of tender feelings toward others. |
____ 29. While improving, a client demands to have a phone installed in the intensive care unit (ICU) room. When a nurse states, “This is not allowed. It is a unit rule.” The client angrily demands to see the doctor. Which approach should the nurse use in this situation?
|
A. |
Provide an explanation for the necessity of the unit rule. |
|
B. |
Assist the client to discuss anger and frustrations. |
|
C. |
Call the physician and relay the request. |
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D. |
Arrange for a phone to be installed in the client’s unit room. |
____ 30. Which nursing statement reflects a common characteristic of a client diagnosed with paranoid personality disorder?
|
A. |
“This client consistently criticizes care and has difficulty getting along with others.” |
|
B. |
“This client is shy and fades into the background.” |
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C. |
“This client expects special treatment and setting limits will be necessary.” |
|
D. |
“This client is expressive during group and is very pleased with self.” |
____ 31. A client exhibits dependency on staff and peers and expresses fear of abandonment. Using Mahler’s theory of object relations, which should the nurse expect to note in this client’s childhood?
|
A. |
Lack of fulfillment of basic needs by parental figures |
|
B. |
Absence of the client’s maternal figure during symbiosis |
|
C. |
Difficulty establishing trust with the maternal figure |
|
D. |
Inconsistency by the maternal figure during individuation |
____ 32. A client diagnosed with cluster “C” traits sits alone and ignores other’s attempts to converse. When ask to join a group the client states, “No thanks.” In this situation, which should the nurse assign as an initial nursing diagnosis?
|
A. |
Fear R/T hospitalization |
|
B. |
Social isolation R/T poor self-esteem |
|
C. |
Risk for suicide R/T to hopelessness |
|
D. |
Powerlessness R/T dependence issues |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 33. Which statements represent positive outcomes for clients diagnosed with narcissistic personality disorder? (Select all that apply.)
|
A. |
The client will relate one empathetic statement toward another client in group by day 2. |
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B. |
The client will identify one personal limitation by day 1. |
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C. |
The client will acknowledge one strength that another client possesses by day 2. |
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D. |
The client will list four personal strengths by day 3. |
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E. |
The client will list two lifetime achievements by discharge. |
____ 34. A nurse is caring for a group of clients within the DSM-IV-TR cluster B category of personality disorders. Which factors should the nurse consider when planning client care? (Select all that apply.)
|
A. |
These clients have personality traits that are deeply ingrained and difficult to modify. |
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B. |
These clients need medications to treat the underlying physiological pathology. |
|
C. |
These clients use manipulation, making the implementation of treatment problematic. |
|
D. |
These clients have poor impulse control that hinders compliance with a plan of care. |
|
E. |
These clients commonly have secondary diagnoses of substance abuse and depression. |
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