Chapter 31. Personality Disorders
Multiple Choice
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?
A. You are very disrespectful. You need to learn to control yourself.
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?
ANS: B
The appropriate nursing statement 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. Antidepressants and anxiolytics are used for symptom relief;
however, there are no specific medications targeted for the treatment of a personality
disorder.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Psychosocial Integrity
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. Im surprised at you.
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 nights
sleep.
ANS: C
The most appropriate response by the staff is to restate the unit rules in a calm,
assertive manner. Because of the probability of manipulative behavior in this client
population, it is imperative to maintain consistent application of rules.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Psychosocial Integrity
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. B. Initially restrain the
client to maintain safety.
C. Use clear, calm statements and a confident physical stance. D. Empathize with the
clients paranoid perceptions.
ANS: C
The most appropriate nursing intervention is to use clear, calm statements and to
assume a confident physical stance. A calm attitude avoids escalating the aggressive
behavior and 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.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Safe and Effective Care Environment
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 B. Schizotypal personality disorder C. Histrionic
personality disorder
D. Manic personality disorder
ANS: C
The nurse should associate histrionic personality disorder with this assessment data.
Individuals diagnosed with histrionic personality disorder tend to be self-dramatizing,
attention seeking, overly gregarious, and seductive. They often use manipulation and
exhibitionism as a means of gaining attention.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Assessment | Client Need:
Psychosocial Integrity
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.
Multiple Choice
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?
A. You are very disrespectful. You need to learn to control yourself.
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?
ANS: B
The appropriate nursing statement 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. Antidepressants and anxiolytics are used for symptom relief;
however, there are no specific medications targeted for the treatment of a personality
disorder.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Psychosocial Integrity
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. Im surprised at you.
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 nights
sleep.
ANS: C
The most appropriate response by the staff is to restate the unit rules in a calm,
assertive manner. Because of the probability of manipulative behavior in this client
population, it is imperative to maintain consistent application of rules.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Psychosocial Integrity
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. B. Initially restrain the
client to maintain safety.
C. Use clear, calm statements and a confident physical stance. D. Empathize with the
clients paranoid perceptions.
ANS: C
The most appropriate nursing intervention is to use clear, calm statements and to
assume a confident physical stance. A calm attitude avoids escalating the aggressive
behavior and 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.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Safe and Effective Care Environment
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 B. Schizotypal personality disorder C. Histrionic
personality disorder
D. Manic personality disorder
ANS: C
The nurse should associate histrionic personality disorder with this assessment data.
Individuals diagnosed with histrionic personality disorder tend to be self-dramatizing,
attention seeking, overly gregarious, and seductive. They often use manipulation and
exhibitionism as a means of gaining attention.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Assessment | Client Need:
Psychosocial Integrity
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.
