A client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. How can the nursing staff best handle this situation?

Maintain consistency of care by open communication to avoid staff manipulation

Maintain unit order by the application of autocratic leadership

Allow the clients to apply the democratic process when developing unit rules

Allow the client spokesperson to verbalize concerns during a unit staff meeting

Answer and Explanation

The Correct Answer is A

A. Maintain consistency of care by open communication to avoid staff manipulation: This is the correct answer. Borderline personality disorder (BPD) clients may engage in splitting behaviors, which involve polarized views of staff as either all good or all bad. Maintaining consistency of care and open communication can help prevent manipulation and ensure fair and transparent interactions.

B. Maintain unit order by the application of autocratic leadership: Autocratic leadership, characterized by a top-down approach with limited input from others, may not be the most effective strategy in this situation. It may lead to resistance from clients and potentially escalate the conflict.

C. Allow the clients to apply the democratic process when developing unit rules: While democratic processes are generally beneficial, allowing clients to unreasonably demand modifications of unit rules without considering the overall impact on the therapeutic environment may not be appropriate. It's important to balance client involvement with maintaining a structured and therapeutic milieu.

D. Allow the client spokesperson to verbalize concerns during a unit staff meeting: While it's important to provide a platform for clients to express concerns, allowing a spokesperson to verbalize concerns during a staff meeting should be done in a manner that maintains order and follows the therapeutic goals of the unit. It should not involve unreasonably demanding modifications without a careful consideration of the impact on the overall treatment milieu.

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Correct Answer is D

Explanation

A. "Why do you think you are being lied about and poisoned?": This question may come across as confrontational or challenging, potentially increasing the client's anxiety or defensiveness. It's important to acknowledge the client's feelings rather than questioning their beliefs directly.

B. "You are mistaken. Nobody is lying about you or trying to poison you.": This statement is dismissive and may cause the client to feel invalidated. It is crucial to acknowledge the client's feelings and experiences, even if they are not based on reality.

C. "Who is lying about you and trying to poison you?": This question may unintentionally reinforce the delusional thinking by suggesting that someone is indeed lying or trying to poison the client. It's essential to avoid validating or encouraging the delusional content.

D. "You seem to be having very frightening thoughts.": This statement acknowledges the client's emotions without directly challenging the delusional content. It shows empathy and creates an open and non-confrontational environment, allowing the client to express their feelings and experiences.

A. Case Manager B. Educator C. Counselor D. Milieu Manager

Correct Answer is D

Explanation

A. Case Manager:

A case manager is typically responsible for coordinating and managing the overall care and services for a client. This role involves collaboration with various healthcare professionals and services outside the immediate treatment setting.

B. Educator:

An educator is involved in providing information, teaching, and promoting the understanding of health-related topics. While education is an essential component of nursing care, the described actions are more indicative of another role.

C. Counselor:

A counselor focuses on providing emotional support, guidance, and therapeutic communication to help clients explore and address personal issues. While nurses do engage in counseling, the described actions emphasize a broader role.

D. Milieu Manager:

The role of a milieu manager involves organizing and maintaining the therapeutic environment, including scheduling activities, managing interactions, and ensuring safety on a psychiatric unit. This role is crucial for creating a supportive and therapeutic atmosphere for clients.

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A client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. How can the nursing staff best handle this situation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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