Test bank for mental health exam 4
During an assessment interview, a client diagnosed with antisocial personality disorder spits,
curses, and refuses to answer questions. Which is the appropriate nursing response to this
behavior?
1. You are very disrespectful. You need to learn to control yourself.
2. I understand that you are angry, but this behavior will not be tolerated.
3. What behaviors could you modify to improve this situation?
4. What anti-personality disorder medications>>> ANS: 2
Rationale: The appropriate nursing response 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.
At 11:00 p.m. a client diagnosed with antisocial personality disorder demands to phone a lawyer
to file for a divorce. Unit rules state that no phone calls are permitted after 10:00 p.m. Which
nursing response is most appropriate?
1. Go ahead and use the phone. I know this pending divorce is stressful.
2. You know better than to break the rules. I'm surprised at you.
3. It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow.
4. A divorce shouldn't be considered until you have had a good nights sleep.>>> 3 ~ The most
appropriate response by the staff is to restate the unit rules in a calm, assertive manner. The nurse
can encourage the client to verbalize frustration while maintaining an accepting attitude. The
nurse may also help the client to identify the true source of frustration.
A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing
intervention is most appropriate?
1. Provide objective evidence that reasons for violence are unwarranted.
2. Initially restrain the client to maintain safety.
,3. Use clear, calm statements and a confident physical stance.
4. Empathize with the clients paranoid perceptions.>>> 3 ~ The most appropriate nursing
intervention is to use clear, calm statements and to assume a confident physical stance. A calm
attitude 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.
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?
1. Allow the clients to apply the democratic process when developing unit rules.
2. Maintain consistency of care by open communication to avoid staff manipulation.
3. Allow the client spokesman to verbalize concerns during a unit staff meeting.
4. Maintain unit order by the application of autocratic leadership.>>> 2 ~ The nursing staff can
best handle this situation by maintaining consistency of care by open communication to avoid
staff manipulation. Clients with borderline personality disorder can exhibit negative patterns of
interaction, such as clinging and distancing, splitting, manipulation, and self-destructive
behaviors.
Which nursing approach should be used to maintain a therapeutic relationship with a client
diagnosed with borderline personality disorder?
1. Being firm, consistent, and empathic, while addressing specific client behaviors
2. Promoting client self-expression by implementing laissez-faire leadership
3. Using authoritative leadership to help clients learn to conform to society norms
4. Overlooking inappropriate behaviors to avoid providing secondary gains>>> 1 ~ The best
nursing approach when working with a client diagnosed with borderline personality disorder is to
be firm, consistent, and empathetic while addressing specific client behaviors. Individuals with
borderline personality disorder always seem to be in a state of crisis and can often have negative
patterns of interaction, such as manipulation and splitting.
Which adult client should a nurse identify as exhibiting the characteristics of a dependent
personality disorder?
1. A physically healthy client who is dependent on meeting social needs by contact with 15 cat
2. A physically healthy client who has a history of depending on intense relationships to meet
basic needs
,3. A physically healthy client who lives with parents and depends on public transportation
4. A physically healthy client who is serious, inflexible, perfectionistic, lacks spontaneity, and
depends on rules to provide security>>> ANS: 3
Rationale: A physically healthy adult client who lives with parents and depends on public
transportation exhibits signs of dependent personality disorder. Dependent personality disorder is
characterized by a pervasive and excessive need to be taken care of that leads to submissive and
clinging behaviors.
A client expresses low self-worth, has much difficulty making decisions, avoids positions of
responsibility, and has a behavioral pattern of suffering in silence. Which statement best explains
the etiology of this clients personality disorder?
1. Childhood nurturance was provided from many sources, and independent behaviors were
encouraged.
2. Childhood nurturance was provided exclusively from one source, and independent behaviors
were discouraged.
3. Childhood nurturance was provided exclusively from one source, and independent behaviors
were encouraged.
4. Childhood nurturance was provided from many sources, and independent behaviors were
discouraged.>>> Ans: 2
Rationale: The behaviors presented in the question represent symptoms of dependent personality
disorder. Nurturance provided from one source and discouragement of independent behaviors
can contribute to the development of this personality disorder. Dependent behaviors may be
rewarded by a parent who is overprotective and discourages autonomy.
Family members of a client ask the nurse to explain the difference between schizoid and
avoidant personality disorders. Which is the appropriate nursing response?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients
diagnosed with schizoid personality disorder prefer to be alone.
2. Clients diagnosed with schizoid personality disorder exhibit delusions and hallucinations,
while clients diagnosed with avoidant personality disorder do not.
3. Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with
schizoid personality disorder are dull and vacant.
4. Clients diagnosed with schizoid personality disorder have a history of psychosis, while clients
diagnosed with avoidant personality disorder remain based in reality.>>> Ans: 1
, Rationale: The nurse should educate the family that clients diagnosed with avoidant personality
disorder desire intimacy but fear it, while clients diagnosed with schizoid personality disorder
prefer to be alone. Schizoid personality disorder is characterized by a profound deficit in the
ability to form personal relationships. Clients diagnosed with schizoid personality disorder may
exhibit odd and eccentric behaviors but not to the extent of psychosis.
Which nursing diagnosis should a nurse identify as appropriate when working with a client
diagnosed with schizoid personality disorder?
1. Altered thought processes R/T increased stress
2. Risk for suicide R/T loneliness
3. Risk for violence: directed toward others R/T paranoid thinking
4. Social isolation R/T inability to relate to others>>> ANS: 4
Rationale: An appropriate nursing diagnosis when working with a client diagnosed with schizoid
personality disorder is social isolation R/T inability to relate to others. Clients diagnosed with
schizoid personality disorder appear cold, aloof, and indifferent to others. They prefer to work in
isolation and are not sociable.
Looking at a slightly bleeding paper cut, the client screams, Somebody help me quick! Im
bleeding. Call 911! A nurse should identify this behavior as characteristic of which personality
disorder?
1. Schizoid personality disorder
2. Obsessive-compulsive personality disorder
3. Histrionic personality disorder
4. Paranoid personality disorder>>> 3 ~ The nurse should identify this behavior as characteristic
of histrionic personality disorder. Individuals with this disorder tend to be self-dramatizing,
attention seeking, over gregarious, and seductive.
When planning care for a client diagnosed with borderline personality disorder, which self- harm
behavior should a nurse expect the client to exhibit?
1. The use of highly lethal methods to commit suicide
2. The use of suicidal gestures to elicit a rescue response from others
3. The use of isolation and starvation as suicidal methods
During an assessment interview, a client diagnosed with antisocial personality disorder spits,
curses, and refuses to answer questions. Which is the appropriate nursing response to this
behavior?
1. You are very disrespectful. You need to learn to control yourself.
2. I understand that you are angry, but this behavior will not be tolerated.
3. What behaviors could you modify to improve this situation?
4. What anti-personality disorder medications>>> ANS: 2
Rationale: The appropriate nursing response 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.
At 11:00 p.m. a client diagnosed with antisocial personality disorder demands to phone a lawyer
to file for a divorce. Unit rules state that no phone calls are permitted after 10:00 p.m. Which
nursing response is most appropriate?
1. Go ahead and use the phone. I know this pending divorce is stressful.
2. You know better than to break the rules. I'm surprised at you.
3. It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow.
4. A divorce shouldn't be considered until you have had a good nights sleep.>>> 3 ~ The most
appropriate response by the staff is to restate the unit rules in a calm, assertive manner. The nurse
can encourage the client to verbalize frustration while maintaining an accepting attitude. The
nurse may also help the client to identify the true source of frustration.
A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing
intervention is most appropriate?
1. Provide objective evidence that reasons for violence are unwarranted.
2. Initially restrain the client to maintain safety.
,3. Use clear, calm statements and a confident physical stance.
4. Empathize with the clients paranoid perceptions.>>> 3 ~ The most appropriate nursing
intervention is to use clear, calm statements and to assume a confident physical stance. A calm
attitude 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.
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?
1. Allow the clients to apply the democratic process when developing unit rules.
2. Maintain consistency of care by open communication to avoid staff manipulation.
3. Allow the client spokesman to verbalize concerns during a unit staff meeting.
4. Maintain unit order by the application of autocratic leadership.>>> 2 ~ The nursing staff can
best handle this situation by maintaining consistency of care by open communication to avoid
staff manipulation. Clients with borderline personality disorder can exhibit negative patterns of
interaction, such as clinging and distancing, splitting, manipulation, and self-destructive
behaviors.
Which nursing approach should be used to maintain a therapeutic relationship with a client
diagnosed with borderline personality disorder?
1. Being firm, consistent, and empathic, while addressing specific client behaviors
2. Promoting client self-expression by implementing laissez-faire leadership
3. Using authoritative leadership to help clients learn to conform to society norms
4. Overlooking inappropriate behaviors to avoid providing secondary gains>>> 1 ~ The best
nursing approach when working with a client diagnosed with borderline personality disorder is to
be firm, consistent, and empathetic while addressing specific client behaviors. Individuals with
borderline personality disorder always seem to be in a state of crisis and can often have negative
patterns of interaction, such as manipulation and splitting.
Which adult client should a nurse identify as exhibiting the characteristics of a dependent
personality disorder?
1. A physically healthy client who is dependent on meeting social needs by contact with 15 cat
2. A physically healthy client who has a history of depending on intense relationships to meet
basic needs
,3. A physically healthy client who lives with parents and depends on public transportation
4. A physically healthy client who is serious, inflexible, perfectionistic, lacks spontaneity, and
depends on rules to provide security>>> ANS: 3
Rationale: A physically healthy adult client who lives with parents and depends on public
transportation exhibits signs of dependent personality disorder. Dependent personality disorder is
characterized by a pervasive and excessive need to be taken care of that leads to submissive and
clinging behaviors.
A client expresses low self-worth, has much difficulty making decisions, avoids positions of
responsibility, and has a behavioral pattern of suffering in silence. Which statement best explains
the etiology of this clients personality disorder?
1. Childhood nurturance was provided from many sources, and independent behaviors were
encouraged.
2. Childhood nurturance was provided exclusively from one source, and independent behaviors
were discouraged.
3. Childhood nurturance was provided exclusively from one source, and independent behaviors
were encouraged.
4. Childhood nurturance was provided from many sources, and independent behaviors were
discouraged.>>> Ans: 2
Rationale: The behaviors presented in the question represent symptoms of dependent personality
disorder. Nurturance provided from one source and discouragement of independent behaviors
can contribute to the development of this personality disorder. Dependent behaviors may be
rewarded by a parent who is overprotective and discourages autonomy.
Family members of a client ask the nurse to explain the difference between schizoid and
avoidant personality disorders. Which is the appropriate nursing response?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients
diagnosed with schizoid personality disorder prefer to be alone.
2. Clients diagnosed with schizoid personality disorder exhibit delusions and hallucinations,
while clients diagnosed with avoidant personality disorder do not.
3. Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with
schizoid personality disorder are dull and vacant.
4. Clients diagnosed with schizoid personality disorder have a history of psychosis, while clients
diagnosed with avoidant personality disorder remain based in reality.>>> Ans: 1
, Rationale: The nurse should educate the family that clients diagnosed with avoidant personality
disorder desire intimacy but fear it, while clients diagnosed with schizoid personality disorder
prefer to be alone. Schizoid personality disorder is characterized by a profound deficit in the
ability to form personal relationships. Clients diagnosed with schizoid personality disorder may
exhibit odd and eccentric behaviors but not to the extent of psychosis.
Which nursing diagnosis should a nurse identify as appropriate when working with a client
diagnosed with schizoid personality disorder?
1. Altered thought processes R/T increased stress
2. Risk for suicide R/T loneliness
3. Risk for violence: directed toward others R/T paranoid thinking
4. Social isolation R/T inability to relate to others>>> ANS: 4
Rationale: An appropriate nursing diagnosis when working with a client diagnosed with schizoid
personality disorder is social isolation R/T inability to relate to others. Clients diagnosed with
schizoid personality disorder appear cold, aloof, and indifferent to others. They prefer to work in
isolation and are not sociable.
Looking at a slightly bleeding paper cut, the client screams, Somebody help me quick! Im
bleeding. Call 911! A nurse should identify this behavior as characteristic of which personality
disorder?
1. Schizoid personality disorder
2. Obsessive-compulsive personality disorder
3. Histrionic personality disorder
4. Paranoid personality disorder>>> 3 ~ The nurse should identify this behavior as characteristic
of histrionic personality disorder. Individuals with this disorder tend to be self-dramatizing,
attention seeking, over gregarious, and seductive.
When planning care for a client diagnosed with borderline personality disorder, which self- harm
behavior should a nurse expect the client to exhibit?
1. The use of highly lethal methods to commit suicide
2. The use of suicidal gestures to elicit a rescue response from others
3. The use of isolation and starvation as suicidal methods
