Test bank for mental health exam 4
During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and
refuses to answer questions. Which is the appropriate nursing response to this behavior?
1. You are very disrespectful. You need to learn to control yourself.
2. I understand that you are angry, but this behavior will not be tolerated.
3. What behaviors could you modify to improve this situation?
4. What anti-personality disorder medications >>> ANS: 2
Rationale: The appropriate nursing response is to reflect the clients feeling while setting firm limits on
behavior. Clients diagnosed with antisocial personality disorder have a low tolerance for frustration, see
themselves as victims, and use projection as a primary ego defense mechanism.
At 11:00 p.m. a client diagnosed with antisocial personality disorder demands to phone a lawyer to file
for a divorce. Unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing response
is most appropriate?
1. Go ahead and use the phone. I know this pending divorce is stressful.
2. You know better than to break the rules. I'm surprised at you.
3. It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow.
4. A divorce shouldn't be considered until you have had a good nights sleep. >>> 3 ~ The most
appropriate response by the staff is to restate the unit rules in a calm, assertive manner. The nurse can
encourage the client to verbalize frustration while maintaining an accepting attitude. The nurse may also
help the client to identify the true source of frustration.
A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing
intervention is most appropriate?
1. Provide objective evidence that reasons for violence are unwarranted.
2. Initially restrain the client to maintain safety.
3. Use clear, calm statements and a confident physical stance.
4. Empathize with the clients paranoid perceptions. >>> 3 ~ The most appropriate nursing intervention
is to use clear, calm statements and to assume a confident physical stance. A calm attitude provides the
,client with a feeling of safety and security. It may also be beneficial to have sufficient staff on hand to
present a show of strength.
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?
1. Allow the clients to apply the democratic process when developing unit rules.
2. Maintain consistency of care by open communication to avoid staff manipulation.
3. Allow the client spokesman to verbalize concerns during a unit staff meeting.
4. Maintain unit order by the application of autocratic leadership. >>> 2 ~ The nursing staff can best
handle this situation by maintaining consistency of care by open communication to avoid staff
manipulation. Clients with borderline personality disorder can exhibit negative patterns of interaction,
such as clinging and distancing, splitting, manipulation, and self-destructive behaviors.
Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed
with borderline personality disorder?
1. Being firm, consistent, and empathic, while addressing specific client behaviors
2. Promoting client self-expression by implementing laissez-faire leadership
3. Using authoritative leadership to help clients learn to conform to society norms
4. Overlooking inappropriate behaviors to avoid providing secondary gains >>> 1 ~ The best nursing
approach when working with a client diagnosed with borderline personality disorder is to be firm,
consistent, and empathetic while addressing specific client behaviors. Individuals with borderline
personality disorder always seem to be in a state of crisis and can often have negative patterns of
interaction, such as manipulation and splitting.
Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality
disorder?
1. A physically healthy client who is dependent on meeting social needs by contact with 15 cat
2. A physically healthy client who has a history of depending on intense relationships to meet basic
needs
3. A physically healthy client who lives with parents and depends on public transportation
4. A physically healthy client who is serious, inflexible, perfectionistic, lacks spontaneity, and depends on
rules to provide security >>> ANS: 3
,Rationale: A physically healthy adult client who lives with parents and depends on public transportation
exhibits signs of dependent personality disorder. Dependent personality disorder is characterized by a
pervasive and excessive need to be taken care of that leads to submissive and clinging behaviors.
A client expresses low self-worth, has much difficulty making decisions, avoids positions of
responsibility, and has a behavioral pattern of suffering in silence. Which statement best explains the
etiology of this clients personality disorder?
1. Childhood nurturance was provided from many sources, and independent behaviors were
encouraged.
2. Childhood nurturance was provided exclusively from one source, and independent behaviors were
discouraged.
3. Childhood nurturance was provided exclusively from one source, and independent behaviors were
encouraged.
4. Childhood nurturance was provided from many sources, and independent behaviors were
discouraged. >>> Ans: 2
Rationale: The behaviors presented in the question represent symptoms of dependent personality
disorder. Nurturance provided from one source and discouragement of independent behaviors can
contribute to the development of this personality disorder. Dependent behaviors may be rewarded by a
parent who is overprotective and discourages autonomy.
Family members of a client ask the nurse to explain the difference between schizoid and avoidant
personality disorders. Which is the appropriate nursing response?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed
with schizoid personality disorder prefer to be alone.
2. Clients diagnosed with schizoid personality disorder exhibit delusions and hallucinations, while clients
diagnosed with avoidant personality disorder do not.
3. Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with
schizoid personality disorder are dull and vacant.
4. Clients diagnosed with schizoid personality disorder have a history of psychosis, while clients
diagnosed with avoidant personality disorder remain based in reality. >>> Ans: 1
Rationale: The nurse should educate the family that clients diagnosed with avoidant personality disorder
desire intimacy but fear it, while clients diagnosed with schizoid personality disorder prefer to be alone.
Schizoid personality disorder is characterized by a profound deficit in the ability to form personal
relationships. Clients diagnosed with schizoid personality disorder may exhibit odd and eccentric
behaviors but not to the extent of psychosis.
, Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed
with schizoid personality disorder?
1. Altered thought processes R/T increased stress
2. Risk for suicide R/T loneliness
3. Risk for violence: directed toward others R/T paranoid thinking
4. Social isolation R/T inability to relate to others >>> ANS: 4
Rationale: An appropriate nursing diagnosis when working with a client diagnosed with schizoid
personality disorder is social isolation R/T inability to relate to others. Clients diagnosed with schizoid
personality disorder appear cold, aloof, and indifferent to others. They prefer to work in isolation and
are not sociable.
Looking at a slightly bleeding paper cut, the client screams, Somebody help me quick! Im bleeding. Call
911! A nurse should identify this behavior as characteristic of which personality disorder?
1. Schizoid personality disorder
2. Obsessive-compulsive personality disorder
3. Histrionic personality disorder
4. Paranoid personality disorder >>> 3 ~ The nurse should identify this behavior as characteristic of
histrionic personality disorder. Individuals with this disorder tend to be self-dramatizing, attention
seeking, over gregarious, and seductive.
When planning care for a client diagnosed with borderline personality disorder, which self- harm
behavior should a nurse expect the client to exhibit?
1. The use of highly lethal methods to commit suicide
2. The use of suicidal gestures to elicit a rescue response from others
3. The use of isolation and starvation as suicidal methods
4. The use of self-mutilation to decrease endorphins in the body >>> 2 ~ The nurse should expect that a
client diagnosed with borderline personality disorder may use suicidal gestures to elicit a rescue
response from others. Repetitive, self-mutilating behaviors are common in borderline personality
disorders that result from feelings of abandonment following separation from significant others.
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?
1. You really dont have to go by that schedule. Id just stay home sick.
During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and
refuses to answer questions. Which is the appropriate nursing response to this behavior?
1. You are very disrespectful. You need to learn to control yourself.
2. I understand that you are angry, but this behavior will not be tolerated.
3. What behaviors could you modify to improve this situation?
4. What anti-personality disorder medications >>> ANS: 2
Rationale: The appropriate nursing response is to reflect the clients feeling while setting firm limits on
behavior. Clients diagnosed with antisocial personality disorder have a low tolerance for frustration, see
themselves as victims, and use projection as a primary ego defense mechanism.
At 11:00 p.m. a client diagnosed with antisocial personality disorder demands to phone a lawyer to file
for a divorce. Unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing response
is most appropriate?
1. Go ahead and use the phone. I know this pending divorce is stressful.
2. You know better than to break the rules. I'm surprised at you.
3. It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow.
4. A divorce shouldn't be considered until you have had a good nights sleep. >>> 3 ~ The most
appropriate response by the staff is to restate the unit rules in a calm, assertive manner. The nurse can
encourage the client to verbalize frustration while maintaining an accepting attitude. The nurse may also
help the client to identify the true source of frustration.
A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing
intervention is most appropriate?
1. Provide objective evidence that reasons for violence are unwarranted.
2. Initially restrain the client to maintain safety.
3. Use clear, calm statements and a confident physical stance.
4. Empathize with the clients paranoid perceptions. >>> 3 ~ The most appropriate nursing intervention
is to use clear, calm statements and to assume a confident physical stance. A calm attitude provides the
,client with a feeling of safety and security. It may also be beneficial to have sufficient staff on hand to
present a show of strength.
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?
1. Allow the clients to apply the democratic process when developing unit rules.
2. Maintain consistency of care by open communication to avoid staff manipulation.
3. Allow the client spokesman to verbalize concerns during a unit staff meeting.
4. Maintain unit order by the application of autocratic leadership. >>> 2 ~ The nursing staff can best
handle this situation by maintaining consistency of care by open communication to avoid staff
manipulation. Clients with borderline personality disorder can exhibit negative patterns of interaction,
such as clinging and distancing, splitting, manipulation, and self-destructive behaviors.
Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed
with borderline personality disorder?
1. Being firm, consistent, and empathic, while addressing specific client behaviors
2. Promoting client self-expression by implementing laissez-faire leadership
3. Using authoritative leadership to help clients learn to conform to society norms
4. Overlooking inappropriate behaviors to avoid providing secondary gains >>> 1 ~ The best nursing
approach when working with a client diagnosed with borderline personality disorder is to be firm,
consistent, and empathetic while addressing specific client behaviors. Individuals with borderline
personality disorder always seem to be in a state of crisis and can often have negative patterns of
interaction, such as manipulation and splitting.
Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality
disorder?
1. A physically healthy client who is dependent on meeting social needs by contact with 15 cat
2. A physically healthy client who has a history of depending on intense relationships to meet basic
needs
3. A physically healthy client who lives with parents and depends on public transportation
4. A physically healthy client who is serious, inflexible, perfectionistic, lacks spontaneity, and depends on
rules to provide security >>> ANS: 3
,Rationale: A physically healthy adult client who lives with parents and depends on public transportation
exhibits signs of dependent personality disorder. Dependent personality disorder is characterized by a
pervasive and excessive need to be taken care of that leads to submissive and clinging behaviors.
A client expresses low self-worth, has much difficulty making decisions, avoids positions of
responsibility, and has a behavioral pattern of suffering in silence. Which statement best explains the
etiology of this clients personality disorder?
1. Childhood nurturance was provided from many sources, and independent behaviors were
encouraged.
2. Childhood nurturance was provided exclusively from one source, and independent behaviors were
discouraged.
3. Childhood nurturance was provided exclusively from one source, and independent behaviors were
encouraged.
4. Childhood nurturance was provided from many sources, and independent behaviors were
discouraged. >>> Ans: 2
Rationale: The behaviors presented in the question represent symptoms of dependent personality
disorder. Nurturance provided from one source and discouragement of independent behaviors can
contribute to the development of this personality disorder. Dependent behaviors may be rewarded by a
parent who is overprotective and discourages autonomy.
Family members of a client ask the nurse to explain the difference between schizoid and avoidant
personality disorders. Which is the appropriate nursing response?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed
with schizoid personality disorder prefer to be alone.
2. Clients diagnosed with schizoid personality disorder exhibit delusions and hallucinations, while clients
diagnosed with avoidant personality disorder do not.
3. Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with
schizoid personality disorder are dull and vacant.
4. Clients diagnosed with schizoid personality disorder have a history of psychosis, while clients
diagnosed with avoidant personality disorder remain based in reality. >>> Ans: 1
Rationale: The nurse should educate the family that clients diagnosed with avoidant personality disorder
desire intimacy but fear it, while clients diagnosed with schizoid personality disorder prefer to be alone.
Schizoid personality disorder is characterized by a profound deficit in the ability to form personal
relationships. Clients diagnosed with schizoid personality disorder may exhibit odd and eccentric
behaviors but not to the extent of psychosis.
, Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed
with schizoid personality disorder?
1. Altered thought processes R/T increased stress
2. Risk for suicide R/T loneliness
3. Risk for violence: directed toward others R/T paranoid thinking
4. Social isolation R/T inability to relate to others >>> ANS: 4
Rationale: An appropriate nursing diagnosis when working with a client diagnosed with schizoid
personality disorder is social isolation R/T inability to relate to others. Clients diagnosed with schizoid
personality disorder appear cold, aloof, and indifferent to others. They prefer to work in isolation and
are not sociable.
Looking at a slightly bleeding paper cut, the client screams, Somebody help me quick! Im bleeding. Call
911! A nurse should identify this behavior as characteristic of which personality disorder?
1. Schizoid personality disorder
2. Obsessive-compulsive personality disorder
3. Histrionic personality disorder
4. Paranoid personality disorder >>> 3 ~ The nurse should identify this behavior as characteristic of
histrionic personality disorder. Individuals with this disorder tend to be self-dramatizing, attention
seeking, over gregarious, and seductive.
When planning care for a client diagnosed with borderline personality disorder, which self- harm
behavior should a nurse expect the client to exhibit?
1. The use of highly lethal methods to commit suicide
2. The use of suicidal gestures to elicit a rescue response from others
3. The use of isolation and starvation as suicidal methods
4. The use of self-mutilation to decrease endorphins in the body >>> 2 ~ The nurse should expect that a
client diagnosed with borderline personality disorder may use suicidal gestures to elicit a rescue
response from others. Repetitive, self-mutilating behaviors are common in borderline personality
disorders that result from feelings of abandonment following separation from significant others.
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?
1. You really dont have to go by that schedule. Id just stay home sick.
