Chapter 29: Personality Disorders
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which statement made by a client demonstrates the characteristics associated with personality
disorders?
a. ―My problem involves only my work relationships.‖
b. ―I follow rules regardless of the situation.‖
c. ―What people think of me is really important to me.‖
d. ―I can‘t concentrate when I‘m around people who don‘t agree with me.‖
ANS: B
Patients with personality disorders suffer lifelong inflexible and dysfunctional patterns of relating
and behaving. The patient experiences subjective distress, usually based on others‘ reactions to
him or her, and functioning is impaired. More than one aspect of personality is involved:
personality disorders are described as pervasive. Behaviors are complex and difficult to manage.
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
2. A patient demonstrating borderline personality disorder says, ―When I met him, he was
perfect and gave me everything. Now I know how bad he really is. He left me alone tonight to
go out with others, so I had to cut myself.‖ Which feature is evident?
a. Splitting
b. Paranoia
c. Grandiosity
d. Submissiveness
ANS: A
Splitting involves the inability to integrate the good and bad aspects of an object, so her
, boyfriend is seen as perfect or entirely bad, not as a person with some traits that she likes and
some that she dislikes. Paranoid tendencies involve feelings of persecution. There is no
indication that the patient is submissive or grandiose.
DIF: Cognitive level: Applying TOP: Nursing process: Evaluation
MSC: Client Needs: Psychosocial Integrity
3. A patient has had long-term conflicts with two siblings over their parents‘ wills. The patient
reacts quickly with anger, suspicious that the siblings are plotting to take all the inheritance.
These characteristics are most consistent with which personality disorder?
a. Schizoid
b. Paranoid
c. Borderline
d. Narcissistic
ANS: B
, The characteristics mentioned in the scenario fit the description of paranoid personality disorder.
Schizoid personality is characterized by shyness, withdrawal, and poor social relationships.
Borderline personality is characterized by problems with identity, self-image, mood, and
impulsivity. Narcissistic personality is characterized by self-importance, grandiosity, and a sense
of entitlement.
DIF: Cognitive level: Applying TOP: Nursing process: Evaluation
MSC: Client Needs: Psychosocial Integrity
4. Which intervention demonstrates the nurse‘s understanding of the management ofbehaviors
demonstrated by a patient diagnosed with borderline personality disorder?
a. Scheduling the client for group grief counseling
b. Arranging for short interactions with unit staff
c. Frequent discussions concerning unit rules and expectations
d. Helping the client de-escalate both verbal and physical anger
ANS: C
Characteristic behaviors of individuals with borderline personality disorder include rapid mood
shifts, impulsive acting out, and manipulation of others in order to avoid rules, as well as
problems with identity, dependency, self-mutilation, and unstable, intense interpersonal
relationships. Anger, short attention span and demonstration of grief are not generally associated
with this type of disorder.
DIF: Cognitive level: Applying TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
5. A nurse caring for a person diagnosed with schizoid personality disorder demonstrates an
understanding of the disorder when making what statement?
a. ―I need to be alert for demonstrates of socially aggressive behavior.‖
b. ―The client will not engage in much conversation with either staff or with other
clients.‖
c. ―Staff will need to be accepting of the client‘s odd personal behaviors.‖
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which statement made by a client demonstrates the characteristics associated with personality
disorders?
a. ―My problem involves only my work relationships.‖
b. ―I follow rules regardless of the situation.‖
c. ―What people think of me is really important to me.‖
d. ―I can‘t concentrate when I‘m around people who don‘t agree with me.‖
ANS: B
Patients with personality disorders suffer lifelong inflexible and dysfunctional patterns of relating
and behaving. The patient experiences subjective distress, usually based on others‘ reactions to
him or her, and functioning is impaired. More than one aspect of personality is involved:
personality disorders are described as pervasive. Behaviors are complex and difficult to manage.
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
2. A patient demonstrating borderline personality disorder says, ―When I met him, he was
perfect and gave me everything. Now I know how bad he really is. He left me alone tonight to
go out with others, so I had to cut myself.‖ Which feature is evident?
a. Splitting
b. Paranoia
c. Grandiosity
d. Submissiveness
ANS: A
Splitting involves the inability to integrate the good and bad aspects of an object, so her
, boyfriend is seen as perfect or entirely bad, not as a person with some traits that she likes and
some that she dislikes. Paranoid tendencies involve feelings of persecution. There is no
indication that the patient is submissive or grandiose.
DIF: Cognitive level: Applying TOP: Nursing process: Evaluation
MSC: Client Needs: Psychosocial Integrity
3. A patient has had long-term conflicts with two siblings over their parents‘ wills. The patient
reacts quickly with anger, suspicious that the siblings are plotting to take all the inheritance.
These characteristics are most consistent with which personality disorder?
a. Schizoid
b. Paranoid
c. Borderline
d. Narcissistic
ANS: B
, The characteristics mentioned in the scenario fit the description of paranoid personality disorder.
Schizoid personality is characterized by shyness, withdrawal, and poor social relationships.
Borderline personality is characterized by problems with identity, self-image, mood, and
impulsivity. Narcissistic personality is characterized by self-importance, grandiosity, and a sense
of entitlement.
DIF: Cognitive level: Applying TOP: Nursing process: Evaluation
MSC: Client Needs: Psychosocial Integrity
4. Which intervention demonstrates the nurse‘s understanding of the management ofbehaviors
demonstrated by a patient diagnosed with borderline personality disorder?
a. Scheduling the client for group grief counseling
b. Arranging for short interactions with unit staff
c. Frequent discussions concerning unit rules and expectations
d. Helping the client de-escalate both verbal and physical anger
ANS: C
Characteristic behaviors of individuals with borderline personality disorder include rapid mood
shifts, impulsive acting out, and manipulation of others in order to avoid rules, as well as
problems with identity, dependency, self-mutilation, and unstable, intense interpersonal
relationships. Anger, short attention span and demonstration of grief are not generally associated
with this type of disorder.
DIF: Cognitive level: Applying TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
5. A nurse caring for a person diagnosed with schizoid personality disorder demonstrates an
understanding of the disorder when making what statement?
a. ―I need to be alert for demonstrates of socially aggressive behavior.‖
b. ―The client will not engage in much conversation with either staff or with other
clients.‖
c. ―Staff will need to be accepting of the client‘s odd personal behaviors.‖
