Mental Health Personality Disorders
Exam Questions with Verified Answers
A client with borderline personality disorder has been admitted to the inpatient unit
because the client has been engaging in wrist cutting. The client's sibling is visiting,
and the sibling asks the nurse to explain why the client sometimes does this. Which
response by the nurse would be most appropriate? - ANSWER-"Sometimes the self-
injurious behavior is undertaken to relieve stress."
R: Clients with borderline personality disorder are impulsive and may respond to
stress by harming themselves. Self-harm is an effort to self-soothe by activating
endogenous endorphins to provide comfort
Which personality disorder would be placed in Cluster B? - ANSWER-Borderline
R: Borderline personality disorder is placed in Cluster B. Avoidant personality is in
Cluster C. Paranoid and schizoid personalities are in Cluster A
The nurse is counseling a 28-year-old client with avoidant personality disorder.
Despite being employed, the client verbalizes having low quality of life due to anxiety
and isolation. Which therapeutic goals does the nurse establish as priority? -
ANSWER-The client will experience increased self-esteem.
R: People with avoidant personality disorder have a pattern of social discomfort,
timidity, and fear of negative evaluation. They are preoccupied with what they
perceive as their own shortcomings and will form relationships with others only if
they believe acceptance is guaranteed. People with this disorder often view
themselves as unattractive and inferior to others and are often socially inept. The
priority goal should address increasing the client's self-esteem.
A nurse is reviewing the medical record of a client diagnosed with antisocial
personality disorder. The nurse notes that the client has had numerous episodes
involving irritability, aggressiveness, and impulsivity and has exhibited callousness
toward others. Based on this information, which nursing diagnosis would the nurse
identify as a priority? - ANSWER-Risk for other-directed violence
R: Although they can be interpersonally charming, these clients can become verbally
and physically abusive if their expectations are not met. Protection of other clients
and staff from manipulative and sometimes abusive behavior is a priority. Thus, a
nursing diagnosis of risk for other-directed violence would be a priority.
Which personality disorder is characterized by an alteration between hostile self-
assertion, such as stubbornness, and excessive dependence? - ANSWER-Passive-
aggressive
, R: Clients diagnosed with passive-aggressive personality disorder may alternate
between hostile self-assertion, such as stubbornness, and excessive dependence,
expressing contrition and guilt.
Clients with borderline personality disorder (BPD) are usually admitted to the
inpatient setting because they exhibit what? - ANSWER-Self-harm
A client on an inpatient psychiatric unit has features of borderline personality
disorder. The client is frequently angry, has an unstable sense of self, and is highly
impulsive. The client can be verbally abusive to staff, who feel manipulated by the
client's behaviors. Which intervention does the nurse determine as priority? -
ANSWER-Setting limits
R: The nurse introduces the use of limit setting when clients engage in manipulative,
acting-out, dependent, or similar inappropriate behaviors
A nurse is caring for a client with schizoid personality trait. When developing a plan
of care for the client, which would a nurse most likely include? - ANSWER-Social
skills training
R: Because individuals with schizoid personality trait often lack customary social
skills, social skills training is useful in enhancing their ability to relate in interpersonal
situations. The primary focus is to increase the client's ability to feel pleasure.
A nurse is interviewing a client and suspects that the client may have narcissistic
personality disorder. Which statement by the client would help support the nurse's
suspicions? - ANSWER-"I have a very important position in life; everyone I know
wants to be like me."
R: Individuals with narcissistic personality disorder are grandiose, have an
inexhaustible need for admiration, and lack empathy. These individuals believe that
they are superior, special, or unique and that others should recognize them in this
way.
When clients diagnosed with borderline personality disorder (BPD) see nurses as
either all good or all bad, the client is using which primitive defense? - ANSWER-
Splitting
R: Because clients with BPD view the world in absolutes, nurses and other treatment
team members are alternately categorized as all good or all bad. This primitive
defense is called splitting, and it presents clinicians with a challenge to work openly
with each other, as well as the client, until the issue can be resolved through team
meetings and clinical supervision.
A 43-year-old female client is observed walking and dancing around the unit dressed
in red high heels and a provocative style of dress. The client is seen sitting on the lap
of a male client on the unit, and they are laughing. Which is the most therapeutic
nursing intervention? - ANSWER-"I need for you to get off his lap, this behavior is not
appropriate."
Exam Questions with Verified Answers
A client with borderline personality disorder has been admitted to the inpatient unit
because the client has been engaging in wrist cutting. The client's sibling is visiting,
and the sibling asks the nurse to explain why the client sometimes does this. Which
response by the nurse would be most appropriate? - ANSWER-"Sometimes the self-
injurious behavior is undertaken to relieve stress."
R: Clients with borderline personality disorder are impulsive and may respond to
stress by harming themselves. Self-harm is an effort to self-soothe by activating
endogenous endorphins to provide comfort
Which personality disorder would be placed in Cluster B? - ANSWER-Borderline
R: Borderline personality disorder is placed in Cluster B. Avoidant personality is in
Cluster C. Paranoid and schizoid personalities are in Cluster A
The nurse is counseling a 28-year-old client with avoidant personality disorder.
Despite being employed, the client verbalizes having low quality of life due to anxiety
and isolation. Which therapeutic goals does the nurse establish as priority? -
ANSWER-The client will experience increased self-esteem.
R: People with avoidant personality disorder have a pattern of social discomfort,
timidity, and fear of negative evaluation. They are preoccupied with what they
perceive as their own shortcomings and will form relationships with others only if
they believe acceptance is guaranteed. People with this disorder often view
themselves as unattractive and inferior to others and are often socially inept. The
priority goal should address increasing the client's self-esteem.
A nurse is reviewing the medical record of a client diagnosed with antisocial
personality disorder. The nurse notes that the client has had numerous episodes
involving irritability, aggressiveness, and impulsivity and has exhibited callousness
toward others. Based on this information, which nursing diagnosis would the nurse
identify as a priority? - ANSWER-Risk for other-directed violence
R: Although they can be interpersonally charming, these clients can become verbally
and physically abusive if their expectations are not met. Protection of other clients
and staff from manipulative and sometimes abusive behavior is a priority. Thus, a
nursing diagnosis of risk for other-directed violence would be a priority.
Which personality disorder is characterized by an alteration between hostile self-
assertion, such as stubbornness, and excessive dependence? - ANSWER-Passive-
aggressive
, R: Clients diagnosed with passive-aggressive personality disorder may alternate
between hostile self-assertion, such as stubbornness, and excessive dependence,
expressing contrition and guilt.
Clients with borderline personality disorder (BPD) are usually admitted to the
inpatient setting because they exhibit what? - ANSWER-Self-harm
A client on an inpatient psychiatric unit has features of borderline personality
disorder. The client is frequently angry, has an unstable sense of self, and is highly
impulsive. The client can be verbally abusive to staff, who feel manipulated by the
client's behaviors. Which intervention does the nurse determine as priority? -
ANSWER-Setting limits
R: The nurse introduces the use of limit setting when clients engage in manipulative,
acting-out, dependent, or similar inappropriate behaviors
A nurse is caring for a client with schizoid personality trait. When developing a plan
of care for the client, which would a nurse most likely include? - ANSWER-Social
skills training
R: Because individuals with schizoid personality trait often lack customary social
skills, social skills training is useful in enhancing their ability to relate in interpersonal
situations. The primary focus is to increase the client's ability to feel pleasure.
A nurse is interviewing a client and suspects that the client may have narcissistic
personality disorder. Which statement by the client would help support the nurse's
suspicions? - ANSWER-"I have a very important position in life; everyone I know
wants to be like me."
R: Individuals with narcissistic personality disorder are grandiose, have an
inexhaustible need for admiration, and lack empathy. These individuals believe that
they are superior, special, or unique and that others should recognize them in this
way.
When clients diagnosed with borderline personality disorder (BPD) see nurses as
either all good or all bad, the client is using which primitive defense? - ANSWER-
Splitting
R: Because clients with BPD view the world in absolutes, nurses and other treatment
team members are alternately categorized as all good or all bad. This primitive
defense is called splitting, and it presents clinicians with a challenge to work openly
with each other, as well as the client, until the issue can be resolved through team
meetings and clinical supervision.
A 43-year-old female client is observed walking and dancing around the unit dressed
in red high heels and a provocative style of dress. The client is seen sitting on the lap
of a male client on the unit, and they are laughing. Which is the most therapeutic
nursing intervention? - ANSWER-"I need for you to get off his lap, this behavior is not
appropriate."
