Exam 19: Personality Disorders

Which nursing strategy leads patients to respond more positivity to limit setting?

The nurse in the emergency department tells the daughter of a patient that her 86-year-old mother has had a stroke.The daughter tearfully asks the nurse,"Who will take care of me now?" When the nurse explores this query,the daughter mentions that her mother always tells her what job to take,what clothes to buy and wear,and what to have for lunch.The daughter states that she needs someone to direct her and reassure her when she gets anxious.With which personality disorder is this presentation most consistent?

The patient tells his primary nurse "I get into trouble because I have hair-trigger responses.I shoot from the hip.Lots of times that gets me into a mess." Which response would be most therapeutic?

A patient with antisocial personality disorder tells Nurse A,"You're a much better nurse than Nurse B said you were." The patient tells Nurse B,"Nurse A's upset with you for some reason." To Nurse C the patient states,"You'd like to think you're perfect,but I've seen three of your mistakes this morning." Which nursing intervention would be most helpful for addressing this behavior?

A patient tells the nurse that he is planning to hire a private detective to follow his wife,who he believes is having an extramarital affair.The patient looks behind the door to be sure no one is eavesdropping and asks the nurse what she did with his medical record after he left.The patient's behaviors are most consistent with a diagnosis of:

The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients,verbally abuses a patient with Alzheimer's disease,flatters his primary nurse,and is detached and superficial during counseling sessions.Which behavior should be the priority focus of limit setting?

An appropriate outcome for a patient with a personality disorder and a nursing diagnosis of Ineffective coping as evidenced by use of manipulation would be that the patient will: _______.

To plan effective interventions,the nurse should understand that the underlying reason a patient with paranoid personality disorder is so critical of others probably lies in the patient's:

A worker is characterized by her co-workers as "painfully shy" and lacking in self-confidence.Her co-workers say she stays in her cubicle all day,never coming out for breaks or lunch.One day after falling on the ice in the parking lot,she goes to the nurse's office,where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy.Which nursing approach or response would be most therapeutic?

In clinical supervision,the nurse caring for the patient with a paranoid personality disorder tells the advanced practice nurse,"I tried being caring and empathetic,but the patient just kept telling me to stay away." Which response by the advanced practice nurse would be best?

A physical therapist recently convicted of multiple counts of Medicare fraud is brought to the emergency department after taking an overdose of sedatives.He tells the nurse,"Sure I overbilled.Why not? Everybody takes advantage of the government.They have too many rules.No one can abide by all of them." These statements can be assessed as showing:

Which statement by a patient with borderline personality disorder best indicates the treatment plan is helping?

A patient with borderline personality disorder has cut her wrists.The physician orders daily dressing changes for the lacerations.The nurse performing this care should:

The nurse has recently set limits for a patient with borderline personality disorder.The patient tells the nurse,"You used to care about me.I thought you were wonderful.Now I can see I was mistaken.You're hateful." Which phenomenon is represented by this response?

Which intervention would be appropriate for a patient with a nursing diagnosis of Ineffective coping as evidenced by manipulation of others?

A teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers.She is now experiencing moderate to severe levels of anxiety.The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team,always demanding that things should be done according to her plans.The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate,and they feel frustrated and angry.The patient states she likes her co-workers and only wanted to help them be successful.The nurse realizes the patient's behaviors are most consistent with:

When told that he is scheduled to interview a patient with narcissistic personality disorder,the nurse can anticipate the assessment findings will include the following:

Which of the following interventions would be appropriate when working with a woman whose nursing diagnosis is Ineffective coping related to impaired impulse control as evidenced by impulsive self-injurious behavior? (Select all that apply. )

A patient with borderline personality disorder has been hospitalized several times after self-injurious behavior and suicide attempts.The patient has entered dialectical behavior therapy on an outpatient basis.During therapy,the advanced practice nurse has been counseling her regarding self-harm behavior management.Today the patient called the nurse and reported "feeling empty and anxious" and wants to cut herself.Which response would best help in this situation?

For which behavior(s)would limit setting be most essential?