Exam 19: Personality Disorders

A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help.His history reveals acting-out behaviors as an adolescent and several adult arrests.The nurse interviews him about his relationship with his wife.Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?

A patient with borderline personality disorder cut her wrists while out on a pass.For future planning,staff should consider that the reason for the self-mutilation is probably related to:

Place the steps for limit setting in the most desirable order.

The characteristic in individuals with personality disorders that makes it most necessary for staff to schedule frequent meetings is:

A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend,who breaks off their relationship.Although she has not self-injured in over 2 months,she makes repeated lacerations on her forearm.Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?

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." These comments can best be assessed as:

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.With which diagnosis is this presentation most consistent?

When a patient with a personality disorder uses manipulation as a way of getting needs met,the staff agree to use limit setting as an intervention.How does limit setting work to reduce manipulation?

While the nurse at the personality disorders clinic is interviewing a patient,the patient constantly scans the environment and frequently interrupts to ask what the nurse means by certain words or phrases.The nurse notes that the patient is very sensitive to the nurse's nonverbal behavior.His responses are often argumentative,sarcastic,and hostile.He suggests that he is being hospitalized "so they can exploit me." The patient's behaviors are most consistent with the clinical picture of:

A patient tells a nurse,"The others won't give me my pain meds early,but you are more understanding,you know what it's like to be in pain,and you don't want to see your patients suffer.Could you find a way to get me my pill now? I won't tell anyone." Which response by the nurse would be most therapeutic?

A patient with paranoid personality disorder is noted to sit alone in a corner of the unit living room.When anyone approaches,the patient is haughty or simply ignores the other person.When staff invite her to join an activity,she tells them,"I do not care to be with people who do not like me." A nursing diagnosis that should be considered is:

The nurse who assesses a patient previously diagnosed as having paranoid personality disorder is most likely to describe the patient as:

A nurse notices that although it is midsummer,a patient with borderline personality disorder has begun wearing long-sleeve shirts.The nurse investigates and discovers that the patient has cut her wrists.Place the nursing responses in the correct order,leaving out those which are inappropriate: A)Call a "Medical Assistance Code." B)Provide support and convey caring. C)Assess the severity of the injury. D)Discuss the patient's feelings. E)Remain neutral while providing first aid. F)Have the patient journal about the event. G)Place the patient under constant one-to-one observation.