C HAPTER 24: P ERSONALITY D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which statement made by a patient diagnosed with borderline personalit y
disorder indicates the treatment plan is effective?
a. I think you are the best nurse on the unit.
b. Im never going to get high on drugs again.
c. I felt empt y and wanted to hurt m yself, so I called you.
d. I hate m y mother. I called her today, and she wasnt home.
ANS: C
Seeking a st aff member instead of impulsivel y self -mutilating shows an
adaptive coping strategy. The incorrec responses demonstrate
idealization, devaluation, and wishful thinking.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 464
TOP: Nursing Process: Evalua tion MSC: Client Needs:
Psychosocial Integrity
2. When preparing to interview a patient diagnosed with narcissistic
personalit y disorder, a nurse can anticipate the assessment findings will
include:
a. preoccupation with minute details; perfectionist.
b. charm, drama, seductiveness; seeking admiration.
c. difficult y being alone; indecisive, submissiveness.
, d. grandiosit y, self -importance, and a sense of entitlement.
ANS: D
The characteristics of grandiosit y, self -importance, and entitlement are
consistent with narcissistic personalit y disorder. Charm, drama,
seductiveness, and admiration seeking are seen in patients with
histrionic personality disorder. Preoccupation with minute details and
perfectionism are seen in individuals with obsessive - compulsive
personalit y disorder. Patients with dependent personalit y disorder often
express difficult y being alone and are indecisive and submissive.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 454 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosoci al Integrit y
3. For which behavior would limit setting be most essential? The patient
who:
a. clings to the nurse and asks for advice about inconsequential
matters.
b. is flirtatious and provocative with staff members of the opposite
sex.
c. is hypervigilant and r efuses to attend unit activities.
d. urges a suspicious patient to hit anyone who stares.
ANS: D
This is a manipulative behavior. Because manipulation violates the
rights of others, limit setting is absolutely necessary. Furthermore,
limit setting is neces sary in this case because the safet y of at least two
, other patients is at risk. Limit setting may occasionall y be used with
dependent behavior (clinging to the nurse) and histrionic behavior
(flirting with staff members), but other therapeutic techniques a re also
useful. Limit setting is not needed for a patient who is hypervigilant
and refuses to attend unit activities; rather, the need to develop trust i
central to patient compliance.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 462
TOP: Nursing Process: Planning MSC: Client Needs:
Safe, Effective Care Environment
4. The nurse caring for an individual demonstrating symptoms of schizot ypal
personalit y disorder would expect assessment findings to include:
a. arrogant, grandiose, and a sense of self -importance.
b. attention seeking, melodramatic, and flirtatious.
c. impulsive, restless, sociall y aggressive behavior.
d. sociall y anxious, rambling stories, peculiar ideas.
ANS: D
Individuals with schizot ypal personalit y disorder do not want to be
involved in rel ationships. They are shy and introverted, speak little,
and prefer fantasy and daydreaming to being involved with real people.
The other behaviors would characteristicall y be noted in narcissistic,
histrionic, and antisocial personalit y disorder. (The educ ator may
reformat this question as multiple response.)
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 452 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which statement made by a patient diagnosed with borderline personalit y
disorder indicates the treatment plan is effective?
a. I think you are the best nurse on the unit.
b. Im never going to get high on drugs again.
c. I felt empt y and wanted to hurt m yself, so I called you.
d. I hate m y mother. I called her today, and she wasnt home.
ANS: C
Seeking a st aff member instead of impulsivel y self -mutilating shows an
adaptive coping strategy. The incorrec responses demonstrate
idealization, devaluation, and wishful thinking.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 464
TOP: Nursing Process: Evalua tion MSC: Client Needs:
Psychosocial Integrity
2. When preparing to interview a patient diagnosed with narcissistic
personalit y disorder, a nurse can anticipate the assessment findings will
include:
a. preoccupation with minute details; perfectionist.
b. charm, drama, seductiveness; seeking admiration.
c. difficult y being alone; indecisive, submissiveness.
, d. grandiosit y, self -importance, and a sense of entitlement.
ANS: D
The characteristics of grandiosit y, self -importance, and entitlement are
consistent with narcissistic personalit y disorder. Charm, drama,
seductiveness, and admiration seeking are seen in patients with
histrionic personality disorder. Preoccupation with minute details and
perfectionism are seen in individuals with obsessive - compulsive
personalit y disorder. Patients with dependent personalit y disorder often
express difficult y being alone and are indecisive and submissive.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 454 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosoci al Integrit y
3. For which behavior would limit setting be most essential? The patient
who:
a. clings to the nurse and asks for advice about inconsequential
matters.
b. is flirtatious and provocative with staff members of the opposite
sex.
c. is hypervigilant and r efuses to attend unit activities.
d. urges a suspicious patient to hit anyone who stares.
ANS: D
This is a manipulative behavior. Because manipulation violates the
rights of others, limit setting is absolutely necessary. Furthermore,
limit setting is neces sary in this case because the safet y of at least two
, other patients is at risk. Limit setting may occasionall y be used with
dependent behavior (clinging to the nurse) and histrionic behavior
(flirting with staff members), but other therapeutic techniques a re also
useful. Limit setting is not needed for a patient who is hypervigilant
and refuses to attend unit activities; rather, the need to develop trust i
central to patient compliance.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 462
TOP: Nursing Process: Planning MSC: Client Needs:
Safe, Effective Care Environment
4. The nurse caring for an individual demonstrating symptoms of schizot ypal
personalit y disorder would expect assessment findings to include:
a. arrogant, grandiose, and a sense of self -importance.
b. attention seeking, melodramatic, and flirtatious.
c. impulsive, restless, sociall y aggressive behavior.
d. sociall y anxious, rambling stories, peculiar ideas.
ANS: D
Individuals with schizot ypal personalit y disorder do not want to be
involved in rel ationships. They are shy and introverted, speak little,
and prefer fantasy and daydreaming to being involved with real people.
The other behaviors would characteristicall y be noted in narcissistic,
histrionic, and antisocial personalit y disorder. (The educ ator may
reformat this question as multiple response.)
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 452 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
