Question 1

When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse can anticipate the assessment findings will include

Accepted Answer

A)   preoccupation with minute details; perfectionist.
B)   charm, drama, seductiveness; seeking admiration.
C)   difficulty being alone; indecisive, submissiveness.
D)   grandiosity, self-importance, and a sense of entitlement. D

Question 2

A new psychiatric technician says, "Schizophrenia … schizotypal! What's the difference?" The nurse's response should include which information?

Accepted Answer

A)   A patient diagnosed with schizophrenia is not usually overtly psychotic.
B)   In schizotypal personality disorder, the patient remains psychotic much longer.
C)   With schizotypal personality disorder, the person can be made aware of misinterpretations of reality.
D)   Schizotypal personality disorder causes more frequent and more prolonged hospitalizations than schizophrenia. C

Question 3

What is an appropriate initial outcome for a patient diagnosed with a personality disorder who frequently manipulates others? The patient will

Accepted Answer

A)   identify when feeling angry.
B)   use manipulation only to get legitimate needs met.
C)   acknowledge manipulative behavior when it is called to his or her attention.
D)   accept fulfillment of his or her requests within an hour rather than immediately. C

Question 4

As a nurse prepares to administer medication to a patient diagnosed with a borderline personality disorder, the patient says, "Just leave it on the table. I'll take it when I finish combing my hair." What is the nurse's best response?

Accepted Answer

A)   Reinforce this assertive action by the patient. Leave the medication on the table as requested.
B)   Respond to the patient, "I'm worried that you might not take it. I'll come back later."
C)   Say to the patient, "I must watch you take the medication. Please take it now."
D)   Ask the patient, "Why don't you want to take your medication now?"

Question 5

The history shows that a newly admitted patient is impulsive. The nurse would expect behavior characterized by

Accepted Answer

A)   adherence to a strict moral code.
B)   manipulative, controlling strategies.
C)   acting without thought on urges or desires.
D)   postponing gratification to an appropriate time.

Question 6

A patient says, "The other nurses won't give me my medication early, but you know what it's like to be in pain and don't let your patients suffer. Could you get me my pill now? I won't tell anyone." Which response by the nurse would be most therapeutic?

Accepted Answer

A)   "I'm not comfortable doing that," and then ignore subsequent requests for early medication.
B)   "I understand that you have pain, but giving medicine too soon would not be safe."
C)   "I'll have to check with your doctor about that; I will get back to you after I do."
D)   "It would be unsafe to give the medicine early; none of us will do that."

Question 7

Which intervention is appropriate for an individual diagnosed with an antisocial personality disorder who frequently manipulates others?

Accepted Answer

A)   Refer requests and questions related to care to the case manager.
B)   Encourage the patient to discuss feelings of fear and inferiority.
C)   Provide negative reinforcement for acting-out behavior.
D)   Ignore, rather than confront, inappropriate behavior.

Question 8

Which characteristic of personality disorders makes it most necessary for staff to schedule frequent team meetings in order to address the patient's needs and maintain a therapeutic milieu?

Accepted Answer

A)   Ability to achieve true intimacy
B)   Flexibility and adaptability to stress
C)   Ability to provoke interpersonal conflict
D)   Inability to develop trusting relationships

Question 9

What is the most challenging nursing intervention with patients diagnosed with personality disorders who use manipulation?

Accepted Answer

A)   Supporting behavioral change
B)   Maintaining consistent limits
C)   Monitoring suicide attempts
D)   Using aversive therapy

Question 10

A nurse determines desired outcomes for a patient diagnosed with schizotypal personality disorder. Select the best outcome. The patient will

Accepted Answer

A)   adhere willingly to unit norms.
B)   report decreased incidence of self-mutilative thoughts.
C)   demonstrate fewer attempts at splitting or manipulating staff.
D)   demonstrate ability to introduce self to a stranger in a social situation.

Question 11

When a patient diagnosed with a personality disorder uses manipulation to get needs met, the staff applies limit-setting interventions. What is the correct rationale for this action?

Accepted Answer

A)   It provides an outlet for feelings of anger and frustration.
B)   It respects the patient's wishes, so assertiveness will develop.
C)   External controls are necessary due to failure of internal control.
D)   Anxiety is reduced when staff assumes responsibility for the patient's behavior.

Question 12

A nurse plans care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors will the nurse expect? (Select all that apply.)

Accepted Answer

A)   Reclusive behavior
B)   Callous attitude
C)   Perfectionism
D)   Aggression
E)   ClinginessF)  Anxiety

Question 13

The nurse caring for an individual demonstrating symptoms of schizotypal personality disorder would expect assessment findings to include

Accepted Answer

A)   arrogant, grandiose, and a sense of self-importance.
B)   attention seeking, melodramatic, and flirtatious.
C)   impulsive, restless, socially aggressive behavior.
D)   socially anxious, rambling stories, peculiar ideas.

Question 14

A patient diagnosed with borderline personality disorder has self-inflicted wrist lacerations. The health care provider prescribes daily dressing changes. The nurse performing this care should

Accepted Answer

A)   maintain a stern and authoritarian affect.
B)   provide care in a matter-of-fact manner.
C)   encourage the patient to express anger.
D)   be very rigid and challenging.

Question 15

What is the priority nursing diagnosis for a patient diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects?

Accepted Answer

A)   Risk for other-directed violence
B)   Risk for self-directed violence
C)   Impaired social interaction
D)   Ineffective denial

Question 16

Personality traits most likely to be documented regarding a patient demonstrating characteristics of an obsessive-compulsive personality disorder are

Accepted Answer

A)   affable, generous.
B)   perfectionist, inflexible.
C)   suspicious, holds grudges.
D)   dramatic speech, impulsive.

Question 17

Consider this comment to three different nurses by a patient diagnosed with an antisocial personality disorder, "Another nurse said you don't do your job right." Collectively, these interactions can be assessed as

Accepted Answer

A)   seductive.
B)   detached.
C)   manipulative.
D)   guilt-producing.

Question 18

One month ago, a patient diagnosed with borderline personality disorder and a history of self-mutilation began dialectical behavior therapy. Today the patient phones to say, "I feel empty and want to hurt myself." The nurse should

Accepted Answer

A)   arrange for emergency inpatient hospitalization.
B)   send the patient to the crisis intervention unit for 8 to 12 hours.
C)   assist the patient to choose coping strategies for triggering situations.
D)   advise the patient to take an antianxiety medication to decrease the anxiety level.

Question 19

For which patients diagnosed with personality disorders would a family history of similar problems be most likely? (Select all that apply.)

Accepted Answer

A)   Obsessive-compulsive
B)   Antisocial
C)   Borderline
D)   Schizotypal
E)   Narcissistic

Question 20

A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed?

Accepted Answer

A)   Benzodiazepine
B)   Mood stabilizing medication
C)   Monoamine oxidase inhibitor (MAOI) 
D)   Cholinesterase inhibitor

Exam 24: Personality Disorders