Chapter 22: Personality Disorders
MULTIPLE CHOICE
1. When analyzing the behaviors of a 23-year-old who meets the criteria for antisocial
personality disorder, the nurse recognizes that which nursing diagnosis would be pertinent to his
care?
a. Risk for self-mutilation
b. Disturbed personal identity
c. Impaired social interaction
d. Social isolation
ANS: C
The patient with antisocial personality disorder is impulsive, manipulative, and dishonest.
Patients with this disorder are frequently involved in illegal matters. Self-mutilation and
disturbed identity are more appropriate for patients with borderline personality disorder. Social
isolation would apply more readily to Cluster A disorders.
2. Which observation is supportive of a diagnosis of avoidant personality disorder?
a. Talks about my three failed marriages
b. Cries loudly whenever requests are denied
c. Fears criticism from others, including staff
d. Shows no remorse when accidentally breaking another patients bracelet
ANS: C
Symptoms suggesting an avoidant personality disorder include fear of rejection, avoidance of
relationships, and censorship of expression of thoughts and feelings because of fear of a negative
reaction. Borderline personality disorder presents with unstable interpersonal relationships, labile
affect, and complaints of emptiness. Patients with histrionic personality disorders are overly
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,dramatic, manipulative, and attention-seeking. Patients with schizoid personality disorder are
indifferent to and lack concern for interpersonal contacts.
3. Which behavior is supportive of a diagnosis of dependent personality disorder?
a. Perceives personal behavior to be embarrassing
b. Believes they are incapable of functioning independently
c. Tends to exaggerate the potential dangers of ordinary situations
d. Demands excessive attention from others whenever in a group situation
ANS: B
The dependent person must rely on others to make decisions and assume responsibility of major
areas of his or her life. Low self-esteem and exaggeration are seen in avoidant personality
disorder. Attention seeking is seen in narcissistic personality disorder.
4. When planning care for a patient with antisocial personality disorder, which consideration has
greatest importance?
a. Addressing the demand for constant attention
b. Teaching coping skills related to frustration tolerance
c. Identifying behaviors related to well-developed superegos
d. Managing the manipulative behaviors resulting from a charming persona
ANS: D
Patients with antisocial personality disorder are described as charming because of their ability to
size up and manipulate others. Narcissistic patients demand constant attention. Patients with
histrionic personality disorder do not tolerate delay of gratification or frustration. Patients with
personality disorder have poorly developed superegos.
5. When a patient diagnosed with borderline personality disorder experiences the death of a
beloved parent, which characteristic response will the nurse anticipate?
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, a. Denies the death for a protracted period of time
b. Exhibits several different psychotic thought processes
c. Expresses extreme anger and rage by burning the parents clothes
d. Becomes uncharacteristically helpful and attends to the funeral arrangements
ANS: C
If a significant person in the patients life dies, the patient with borderline personality disorder
cannot mourn but often exhibits one or more of the six constituent states that include anger and
rage. The other options are not characteristically seen as mourning behaviors in individuals with
this diagnosis.
6. A 27-year-old woman diagnosed with borderline personality disorder displays a labile affect,
impulsivity, frequent angry outbursts, and difficulty tolerating her angry feelings without self-
injury. A priority nursing diagnosis for this patient is:
a. Anxiety
b. Risk for self-mutilation
c. Risk for other-directed violence
d. Ineffective coping
ANS: B
Patients with borderline personality disorder frequently engage in self-mutilation in an attempt to
manage chaotic feelings. The important clue to this diagnosis is that the patient is having
difficulty tolerating feelings without self-injuring. There is no data to support anxiety or
ineffective coping. The risk is greater for violence toward self.
7. Which outcome has priority for a patient with borderline personality disorder being discharged
from an outpatient treatment environment?
a. Patient demonstrates control over self-destructive impulses.
b. Patient can identify symptoms that indicate a need for psychotherapy.
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MULTIPLE CHOICE
1. When analyzing the behaviors of a 23-year-old who meets the criteria for antisocial
personality disorder, the nurse recognizes that which nursing diagnosis would be pertinent to his
care?
a. Risk for self-mutilation
b. Disturbed personal identity
c. Impaired social interaction
d. Social isolation
ANS: C
The patient with antisocial personality disorder is impulsive, manipulative, and dishonest.
Patients with this disorder are frequently involved in illegal matters. Self-mutilation and
disturbed identity are more appropriate for patients with borderline personality disorder. Social
isolation would apply more readily to Cluster A disorders.
2. Which observation is supportive of a diagnosis of avoidant personality disorder?
a. Talks about my three failed marriages
b. Cries loudly whenever requests are denied
c. Fears criticism from others, including staff
d. Shows no remorse when accidentally breaking another patients bracelet
ANS: C
Symptoms suggesting an avoidant personality disorder include fear of rejection, avoidance of
relationships, and censorship of expression of thoughts and feelings because of fear of a negative
reaction. Borderline personality disorder presents with unstable interpersonal relationships, labile
affect, and complaints of emptiness. Patients with histrionic personality disorders are overly
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,dramatic, manipulative, and attention-seeking. Patients with schizoid personality disorder are
indifferent to and lack concern for interpersonal contacts.
3. Which behavior is supportive of a diagnosis of dependent personality disorder?
a. Perceives personal behavior to be embarrassing
b. Believes they are incapable of functioning independently
c. Tends to exaggerate the potential dangers of ordinary situations
d. Demands excessive attention from others whenever in a group situation
ANS: B
The dependent person must rely on others to make decisions and assume responsibility of major
areas of his or her life. Low self-esteem and exaggeration are seen in avoidant personality
disorder. Attention seeking is seen in narcissistic personality disorder.
4. When planning care for a patient with antisocial personality disorder, which consideration has
greatest importance?
a. Addressing the demand for constant attention
b. Teaching coping skills related to frustration tolerance
c. Identifying behaviors related to well-developed superegos
d. Managing the manipulative behaviors resulting from a charming persona
ANS: D
Patients with antisocial personality disorder are described as charming because of their ability to
size up and manipulate others. Narcissistic patients demand constant attention. Patients with
histrionic personality disorder do not tolerate delay of gratification or frustration. Patients with
personality disorder have poorly developed superegos.
5. When a patient diagnosed with borderline personality disorder experiences the death of a
beloved parent, which characteristic response will the nurse anticipate?
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, a. Denies the death for a protracted period of time
b. Exhibits several different psychotic thought processes
c. Expresses extreme anger and rage by burning the parents clothes
d. Becomes uncharacteristically helpful and attends to the funeral arrangements
ANS: C
If a significant person in the patients life dies, the patient with borderline personality disorder
cannot mourn but often exhibits one or more of the six constituent states that include anger and
rage. The other options are not characteristically seen as mourning behaviors in individuals with
this diagnosis.
6. A 27-year-old woman diagnosed with borderline personality disorder displays a labile affect,
impulsivity, frequent angry outbursts, and difficulty tolerating her angry feelings without self-
injury. A priority nursing diagnosis for this patient is:
a. Anxiety
b. Risk for self-mutilation
c. Risk for other-directed violence
d. Ineffective coping
ANS: B
Patients with borderline personality disorder frequently engage in self-mutilation in an attempt to
manage chaotic feelings. The important clue to this diagnosis is that the patient is having
difficulty tolerating feelings without self-injuring. There is no data to support anxiety or
ineffective coping. The risk is greater for violence toward self.
7. Which outcome has priority for a patient with borderline personality disorder being discharged
from an outpatient treatment environment?
a. Patient demonstrates control over self-destructive impulses.
b. Patient can identify symptoms that indicate a need for psychotherapy.
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