NUR 208/NUR208 Exam 4 V3 | Mental Health
Nursing Q&A with Rationale | Fortis College
1. A client with Borderline Personality Disorder is being admitted to the psychiatric unit.
Which characteristic should the nurse expect to observe?
A. Extreme social isolation and lack of interest in relationships
B. Grandiosity and a constant need for admiration from others
C. Instability in interpersonal relationships, self-image, and affect
D. A pervasive pattern of disregard for the rights of others
Correct Answer: C
Explanation: Borderline Personality Disorder is primarily characterized by significant
instability in moods and self-identity. Clients often experience intense episodes of anger,
depression, and anxiety that can last from a few hours to days. These patients frequently
utilize defense mechanisms like splitting to manage their fear of abandonment.
2. A nurse is caring for a client who views the nursing staff as either ‘all good’ or ‘all bad.’
Which defense mechanism is this client demonstrating?
A. Projection
B. Splitting
C. Rationalization
D. Reaction Formation
,Correct Answer: B
Explanation: Splitting is a common defense mechanism found in individuals with
Borderline Personality Disorder where they cannot integrate positive and negative
qualities of others. This behavior often leads to conflict within the healthcare team as the
client plays staff members against each other. Nurses must maintain consistent boundaries
and communication to prevent this behavior from disrupting care.
3. Which clinical manifestation is a hallmark sign of Narcissistic Personality Disorder?
A. Excessive emotionality and attention-seeking behavior
B. Fear of rejection and social inhibition
C. A sense of entitlement and lack of empathy for others
D. Preoccupation with orderliness and perfectionism
Correct Answer: C
Explanation: Individuals with Narcissistic Personality Disorder typically exhibit an
inflated sense of self-importance and a deep need for excessive attention. They often lack
empathy and are unable to recognize the needs or feelings of those around them. This
grandiosity often masks a fragile self-esteem that is vulnerable to the slightest criticism.
4. A client with Antisocial Personality Disorder is manipulative and repeatedly breaks unit
rules. What is the most appropriate nursing intervention?
A. Allow the client to explain their reasons for breaking rules
B. Negotiate the rules with the client to encourage compliance
, C. Set firm, consistent limits and consequences for behavior
D. Provide extra attention to the client to build trust
Correct Answer: C
Explanation: Clients with Antisocial Personality Disorder often try to manipulate others to
get their way and avoid responsibility. Setting firm and consistent limits is essential to
maintain safety and therapeutic structure on the unit. Consequences for breaking rules
must be applied immediately and consistently by all staff members.
5. A nurse is assessing a client for Schizotypal Personality Disorder. Which finding would
support this diagnosis?
A. A desire to be the center of attention at all times
B. Extreme submissiveness and a need to be taken care of
C. Magical thinking and odd beliefs that influence behavior
D. A history of physical aggression and criminal activity
Correct Answer: C
Explanation: Schizotypal Personality Disorder is characterized by severe social anxiety
and eccentric behaviors or speech. Clients often experience ideas of reference or magical
thinking, such as believing they have telepathic powers. These oddities distinguish it from
simple social phobia or avoidant personality patterns.
Nursing Q&A with Rationale | Fortis College
1. A client with Borderline Personality Disorder is being admitted to the psychiatric unit.
Which characteristic should the nurse expect to observe?
A. Extreme social isolation and lack of interest in relationships
B. Grandiosity and a constant need for admiration from others
C. Instability in interpersonal relationships, self-image, and affect
D. A pervasive pattern of disregard for the rights of others
Correct Answer: C
Explanation: Borderline Personality Disorder is primarily characterized by significant
instability in moods and self-identity. Clients often experience intense episodes of anger,
depression, and anxiety that can last from a few hours to days. These patients frequently
utilize defense mechanisms like splitting to manage their fear of abandonment.
2. A nurse is caring for a client who views the nursing staff as either ‘all good’ or ‘all bad.’
Which defense mechanism is this client demonstrating?
A. Projection
B. Splitting
C. Rationalization
D. Reaction Formation
,Correct Answer: B
Explanation: Splitting is a common defense mechanism found in individuals with
Borderline Personality Disorder where they cannot integrate positive and negative
qualities of others. This behavior often leads to conflict within the healthcare team as the
client plays staff members against each other. Nurses must maintain consistent boundaries
and communication to prevent this behavior from disrupting care.
3. Which clinical manifestation is a hallmark sign of Narcissistic Personality Disorder?
A. Excessive emotionality and attention-seeking behavior
B. Fear of rejection and social inhibition
C. A sense of entitlement and lack of empathy for others
D. Preoccupation with orderliness and perfectionism
Correct Answer: C
Explanation: Individuals with Narcissistic Personality Disorder typically exhibit an
inflated sense of self-importance and a deep need for excessive attention. They often lack
empathy and are unable to recognize the needs or feelings of those around them. This
grandiosity often masks a fragile self-esteem that is vulnerable to the slightest criticism.
4. A client with Antisocial Personality Disorder is manipulative and repeatedly breaks unit
rules. What is the most appropriate nursing intervention?
A. Allow the client to explain their reasons for breaking rules
B. Negotiate the rules with the client to encourage compliance
, C. Set firm, consistent limits and consequences for behavior
D. Provide extra attention to the client to build trust
Correct Answer: C
Explanation: Clients with Antisocial Personality Disorder often try to manipulate others to
get their way and avoid responsibility. Setting firm and consistent limits is essential to
maintain safety and therapeutic structure on the unit. Consequences for breaking rules
must be applied immediately and consistently by all staff members.
5. A nurse is assessing a client for Schizotypal Personality Disorder. Which finding would
support this diagnosis?
A. A desire to be the center of attention at all times
B. Extreme submissiveness and a need to be taken care of
C. Magical thinking and odd beliefs that influence behavior
D. A history of physical aggression and criminal activity
Correct Answer: C
Explanation: Schizotypal Personality Disorder is characterized by severe social anxiety
and eccentric behaviors or speech. Clients often experience ideas of reference or magical
thinking, such as believing they have telepathic powers. These oddities distinguish it from
simple social phobia or avoidant personality patterns.
