A client who has a borderline personality disorder is being discharged today. When the nurse makes morning rounds, the client begins the interaction by claiming the night shift nurse is aloof and expresses joy to see that, "My favorite nurse is on duty now." Which response is best for the nurse to provide to this client's dichotomous tendency?
"I am happy that you are getting better and will be able to go home."
"Tomorrow I will talk to that nurse about how you were treated last night."
"I am glad you like me. Which nurse was acting aloof to you?"
"What did the night nurse do that makes you think the nurse is aloof?"
The Correct Answer is A
A. "I am happy that you are getting better and will be able to go home."
This response focuses on the client’s progress and avoids engaging with their polarized views. It provides positive reinforcement and shifts the focus toward recovery.
B. "Tomorrow I will talk to that nurse about how you were treated last night."
This could escalate the situation and may inadvertently validate the client's idealization or devaluation of others, without fully understanding the dynamics.
C. "I am glad you like me. Which nurse was acting aloof to you?"
This response reinforces the client’s idealization of the current nurse, which could perpetuate dichotomous thinking.
D. "What did the night nurse do that makes you think the nurse is aloof?"
This invites the client to focus on negative perceptions of the night nurse, potentially escalating their emotional instability.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Connect the nasogastric tube to suction as prescribed: "Coffee ground" drainage can indicate the presence of blood in the stomach, which requires further assessment before initiating suction.
B. Clamp the nasogastric tube and contact the healthcare provider: Clamping the tube helps
prevent further aspiration of gastric contents, and contacting the healthcare provider is necessary for further evaluation and instructions.
C. Immediately remove and then reinsert the nasogastric tube: While removing and reinserting the tube may be necessary, contacting the healthcare provider for guidance is the priority.
D. Connect the nasogastric tube to high continuous suction: Initiating suction without further evaluation can exacerbate bleeding and is not appropriate without guidance from the healthcare provider.
Correct Answer is C
Explanation
A. Encouraging the client to participate in group activities may be beneficial but may not address the immediate need for increased communication and engagement.
B. Scheduling a daily conference with the social worker may provide support but may not directly address the client's withdrawal and noncommunicative behavior.
C. Engaging the client in non-threatening conversations is important to assess the client's current emotional state, understand the reasons for withdrawal, and provide support and encouragement for communication and interaction.
D. Encouraging the client's family to visit more often may be helpful for social support, but it may not address the underlying issue of the client's withdrawal and noncommunicative behavior.
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