Deck 29: Personality Disorders

Question 1

A patient demonstrating borderline personality disorder says, "When I met him, he was perfect and gave me everything.Now I know how bad he really is.He left me alone tonight to go out with others, so I had to cut myself." Which feature is evident?

A) Splitting
B) Paranoia
C) Grandiosity
D) Submissiveness

Answer 1

Splitting

Question 2

Which personality traits most likely describe a patient diagnosed with obsessive-compulsive personality disorder?

A) Friendly; generous
B) Dramatic; impulsive
C) Perfectionist; inflexible
D) Suspicious; submissive

Answer 2

Perfectionist; inflexible

Question 3

An adult has a history of intoxication and promiscuity.After stealing money from a grandparent, this person says, "I deserved that money.My family had no right to press charges against me." The scenario depicts features of which personality disorder?

A) Histrionic
B) Narcissistic
C) Antisocial
D) Borderline

Answer 3

Antisocial

Question 4

When caring for a patient diagnosed with dependent personality disorder, the nurse should positively reinforce which behavior?

A) Choosing which clothing to wear
B) Asking another patient for advice
C) Sitting next to the nurse at a community meeting
D) Concealing anger with a family member

Question 5

Which assessment data is commonly noted among clients diagnosed with avoidant personality disorders?

A) Claims to enjoy risk-taking behaviors.
B) Regularly acts impulsively.
C) Displays evidence of poor self-confidence.
D) Demonstrates helplessness as a means of manipulation.

Question 6

A patient has had long-term conflicts with two siblings over their parents' wills.The patient reacts quickly with anger, suspicious that the siblings are plotting to take all the inheritance.These characteristics are most consistent with which personality disorder?

A) Schizoid
B) Paranoid
C) Borderline
D) Narcissistic

Question 7

Which nursing intervention is most likely to result in heightened self-awareness for a patient diagnosed with a personality disorder in the dramatic-erratic cluster?

A) Setting firm limits on behavior
B) Providing clear expectations for acceptable behavior
C) Using confrontational approaches to reduce self-mutilation
D) Encouraging the patient to keep a daily journal to be shared with the nurse

Question 8

A person recently sustained a paper cut on a finger and called an ambulance.Later when discussing the incidence the person says, "I can't believe my supervisor denied my sick leave request." This behavior is most related to which mental health diagnosis?

A) Dependent personality disorder
B) Histrionic personality disorder
C) Antisocial personality disorder
D) Borderline personality disorder

Question 9

Which statement made by a client demonstrates the characteristics associated with personality disorders?

A) "My problem involves only my work relationships."
B) "I follow rules regardless of the situation."
C) "What people think of me is really important to me."
D) "I can't concentrate when I'm around people who don't agree with me."

Question 10

The history of an individual diagnosed with borderline personality disorder often includes what assessment data?

A) The loss of a parent at an early age
B) A family history of bipolar disorder
C) A dysfunctional, abusive childhood
D) An overindulged childhood with few limits

Question 11

Characteristic behaviors a nurse would expect when working with a patient diagnosed with narcissistic personality disorder are:

A) preoccupied with details; perfectionism.
B) socially isolated; odd, eccentric behavior.
C) dramatic expression; easily influenced by others.
D) grandiosity; sense of entitlement; lack of empathy.

Question 12

A patient diagnosed with borderline personality disorder has demonstrated self-mutilation and inappropriate expressions of anger.Which statement by the patient would the nurse evaluate as an improvement?

A) "I think you are the nicest nurse on the unit."
B) "I got drunk last night, but I won't ever do it again."
C) "I felt like cutting myself, so I came to talk to you."
D) "I hate my friends.They never help me when I need it."

Question 13

Which characteristic of individuals diagnosed with personality disorders in the dramatic-erratic cluster makes it advisable for staff to have frequent patient-centered meetings?

A) Manipulating others to avoid limits
B) Behaving responsibly in the peer group
C) Withdrawing from interactions with others
D) Depending excessively on others for support

Question 14

A distinctive characteristic in a patient with antisocial personality disorder is manifested in which behavior?

A) Expressing a high degree of guilt and remorse
B) Showing no regret over stealing another's patient's ring
C) Unwillingness to comply with prescribed antipsychotic therapy
D) Requiring frequent reinforcement of personal self-worth

Question 15

A clinic nurse encounters a new patient diagnosed with schizoid personality disorder.What is the best initial nursing intervention?

A) Set firm limits.
B) Engage in trust building.
C) Involve the patient in group activities.
D) Encourage identification of feelings.

Question 16

Which intervention demonstrates the nurse's understanding of the management of behaviors demonstrated by a patient diagnosed with borderline personality disorder?

A) Scheduling the client for group grief counseling
B) Arranging for short interactions with unit staff
C) Frequent discussions concerning unit rules and expectations
D) Helping the client de-escalate both verbal and physical anger

Question 17

A nurse caring for a person diagnosed with schizoid personality disorder demonstrates an understanding of the disorder when making what statement?

A) "I need to be alert for demonstrates of socially aggressive behavior."
B) "The client will not engage in much conversation with either staff or with other clients."
C) "Staff will need to be accepting of the client's odd personal behaviors."
D) "I expect the client to be socially cold and standoffish."

Question 18

Since admission, a patient diagnosed with antisocial personality disorder has been highly manipulative and constantly tests staff.Now, the patient insists on watching a late movie instead of complying with the bedtime.Select the nurse's best response.

A) "It's a unit rule that bedtime is at 10 P.M."
B) "I will not allow you to manipulate me again."
C) "If you ask again, tomorrow's bedtime will be 9 P.M."
D) "I understand your sleep problems and can allow it just this once."

Question 19

When contrasting schizophrenia and schizotypal personality disorder with other staff members, which statement made by the nurse demonstrates an understanding of the disorder?

A) "In schizotypal personality disorder, the patient remains psychotic much longer."
B) "The patient with schizophrenia has better social skills and is not usually overtly psychotic."
C) "The person with schizotypal personality disorder may have cognitive distortions but not psychosis."
D) "Schizotypal personality disorder is associated with more frequent and prolonged hospitalizations."

Question 20

Patients diagnosed with dependent personality disorders behave submissively and cling to others.What is the best explanation of this behavior?

A) The patients are afraid of being alone or functioning without direction.
B) The patients adhere to strict standards and fear failure.
C) The patients have little regard for the rights of others.
D) The patients are suspicious of the motives of others.

Question 21

A patient diagnosed with borderline personality disorder impulsively self-mutilates and has severe mood lability with explosive outbursts, poor interpersonal relations, and inability to sustain employment.Which referrals should the nurse consider for the patient? (Select all that apply.)

A) Dialectic behavior therapy
B) Alcoholics Anonymous
C) Vocational rehabilitation
D) Desensitization therapy
E) Anger management

Question 22

A psychiatric nursing assistant says, "I get annoyed with patients who self-mutilate over things other people would ignore.I think they just do it to get attention." What is the nurse's best response to take advantage of this teachable moment?

A) "Many people feel the way you do.If you are unable to come to terms with the issue, we can transfer you."
B) "Self-mutilation is a serious problem.Patients with this personality disorder may complete suicide."
C) "We have to consider each case individually.Some are manipulative, and others are serious."
D) "You seem to be having difficulty empathizing and remaining nonjudgmental."

Question 23

Which patient behavior demonstrates the best outcome for a patient with schizotypal personality disorder?

A) Adhering willingly to program norms
B) Talking to a stranger in a social situation
C) Reporting decreased incidence of impulses to self-mutilate
D) Demonstrating fewer attempts at splitting or manipulating staff

Question 24

Which behaviors create interpersonal relationship problems for an individual diagnosed with narcissistic personality disorder? (Select all that apply.)

A) Grandiose self-importance
B) Sense of entitlement
C) Lack of empathy
D) Risk-taking
E) Shyness