NUR 326 - Exam 2 PSYCH, Questions with
Answers 2023
Describe the general diagnostic criteria for personality disorders. (6) - -1.
Enduring pattern of inner experience and behavior that deviates from
person's culture and is manifested in at least two of the following: cognition,
affect, interpersonal functioning or impulse control.
2. Inflexible and pervasive across personal and social situations
3. Pattern is stable and of long duration and can be traced back to
adolescence or early adulthood.
4. Leads to clinically significant distress or impairment in social, occupational
or other important areas of functioning.
5. Pattern is not better accounted for by another mental disorder
Pattern is not due to the direct physiological effects of a substance or
medical condition.
-The nursing diagnosis that would be most appropriate for a 22-year old
client who uses ritualistic behavior would be:
A. Ineffective coping
B. Impaired adjustment
C. Personal identity disturbance
D. Sensory/perceptual alterations - -A (Ineffective coping is the impairment
of a person's adaptive behaviors and problem-solving abilities in meeting
life's demands; ritualistic behavior fits under this category as a defining
characteristic.)
-A 20-year old college student has been brought to the psychiatric hospital
by her parents. Her admitting diagnosis is borderline personality disorder.
When talking with the parents, which information would the nurse expect to
be included in the client's history? Select all that apply.
a. Impulsiveness
b. Lability of mood
c. Ritualistic behavior
d. psychomotor retardation
e. Self-destructive behavior - -A B E
-A hospitalized client, diagnosed with a borderline personality disorder,
consistently breaks the unit's rules. This behavior should be confronted
because it will help the client:
A. Control anger
B. Reduce anxiety
,C. Set realistic goals
D. Become more self-aware - -D (Client's must first become aware of their
behavior before they can change it. Option C occurs after the client is aware
of the behavior and has a desire to change the behavior.)
-When working with the nurse during the orientation phase of the
relationship, a client with a borderline personality disorder would probably
have the most difficulty in:
A. Controlling anxiety
B. Terminating the session on time
C. Accepting the psychiatric diagnosis
D. Setting mutual goals for the relationship - -D (Clients with borderline
personality disorders frequently demonstrate a pattern of unstable
interpersonal relationships, impulsiveness, affective instability, and frantic
efforts to avoid abandonment; these behaviors usually create great difficulty
in establishing mutual goals.)
-A client with a diagnosis of borderline personality disorder has negative
feelings toward the other clients on the unit and considers them all to be
"bad." The nurse understands this defense is known as:
A. Splitting
B. Ambivalence
C. Passive aggression
D. Reaction formation - -A (Splitting is the compartmentalization of opposite-
affect states and failure to integrate the positive and negative aspects of self
or others.)
-A person with antisocial personality disorder has difficulty relating to others
because of never having learned to:
A. Count on others
B. Empathize with others
C. Be dependent on others
D. Communicate with others socially - -B
-When caring for a client with a diagnosis of schizotypal personality disorder,
the nurse should:
A. Set limits on manipulative behavior
B. Encourage participation in group therapy
C. Respect the client's needs for social isolation
D. Understand that seductive behavior is expected. - -C (These clients are
withdrawn, aloof, and socially distant; allowing distance and providing
support may encourage the eventual development of a therapeutic alliance.
, Group therapy would increase this client's anxiety; cognitive or behavioral
therapy would be more appropriate.)
-A client with a diagnosis of narcissistic personality disorder has been given
a day pass from the psychiatric hospital. The client is due to return at 6pm.
At 5pm the client telephones the nurse in charge of the unit and says "6
o'clock is too early. I feel like coming back at 7:30." The nurse would be most
therapeutic by telling the client to:
A. Return immediately, to demonstrate control
B. Return on time or restrictions will be imposed
C. Come back at 6:45, as a compromise to set limits
D. Come back as soon as possible or the police will be sent - -B (This sets
limits, points out reality, and places responsibility for behavior on the client.)
-An adult client with a borderline personality disorder become nauseated
and vomits immediately after drinking after drinking 2 ounces of shampoo as
a suicide gesture. The most appropriate initial response by the nurse would
be to:
A. Promptly notify the attending physician
B. Immediately initiate suicide precautions
C. Sit quietly with the client until nausea and vomiting subsides
D. Assess the client's vital signs and administer syrup of ipecac - -C (This
intervention demonstrates the nurse's caring presence which is vital for this
client. (1) Although the treatment team does need to know about the event,
notification is not the immediate concern. (2) This is premature and it
reinforces the client's predisposition to manipulative behavior. (4) This
medication is inappropriate in this situation; vomiting would be expected
after the ingestion of shampoo.)
-A nurse notices that a client is mistrustful and shows hostile behavior.
Which of the following types of personality disorder is associated with these
characteristics?
A. Antisocial
B. Avoidant
C. Borderline
D. Paranoid - -D (Paranoid individuals have a need to constantly scan the
environment for signs of betrayal, deception, and ridicule, appearing
mistrustful and hostile. They expect to be tricked or deceived by others.)
-Which of the following statements is typical for a client diagnosed with a
paranoid personality disorder?
A. "I understand you're the one to blame."
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