A client with borderline personality disorder reported to the nurse in the clinic that they feel empty and anxious and wants to cut their arms. The nurse should:

advise the client to take an anxiolytic to decrease their anxiety level.

restrain the client to prevent self-harm.

assist the client to identify the trigger situation and choose a coping strategy.

encourage the client use self-harm behaviors to release emotion.

Answer and Explanation

The Correct Answer is C

C. Individuals with borderline personality disorder often struggle with intense emotions and may engage in self-harming behaviors as a maladaptive coping mechanism. Helping the client identify triggers for their distress and teaching them alternative coping strategies, such as mindfulness, grounding techniques, or distress tolerance skills, can empower them to manage their emotions in healthier ways.
A. Anxiolytic medications can help alleviate anxiety symptoms but they are not typically the first-line intervention for addressing acute distress in individuals with borderline personality disorder (BPD).
B. Restraint should not be the first response to a client expressing distress or suicidal ideation. Physical restraint should only be used as a last resort in situations where there is an imminent risk of harm to the client or others and should be implemented by trained professionals following established protocols.
D. Encouraging self-harm behaviors reinforces maladaptive coping strategies and can increase the risk of harm to the client. It is essential to provide support and interventions aimed at reducing self-harming behaviors.

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Correct Answer is B

Explanation

B. Tricyclic antidepressants (TCAs) are known to take some time before their full therapeutic effects are realized, which can indeed be up to four weeks. This delay is due to the gradual changes they induce in the brain's biochemistry.
A. TCAs can cause a variety of side effects but hypomania and recent memory impairment are not typically associated with these medications.
C. TCAs do not have a known interaction with antianxiety agents that would prohibit their concurrent use.
D. The restriction on eating strong or aged cheese is associated with another class of antidepressants known as monoamine oxidase inhibitors (MAOIs), not TCAs.

A. denial. B. separation-individuation. C. splitting. D. reaction formation.

Correct Answer is C

Explanation

C. Splitting is characterized by viewing people and situations in extremes, either all good or all bad, without recognizing the complexity that usually exists in most circumstances. This black-and-white thinking can lead to rapidly shifting perceptions of others, as seen in the client's sudden change from idealizing the nurse to devaluing them.
A. Denial is a defense mechanism where the individual refuses to accept reality or acknowledge an aspect of reality that is apparent to others. In this scenario, the client is not denying any aspect of reality.
B. Separation-individuation is a developmental process where individuals establish autonomy and a sense of self separate from others, particularly from primary caregivers. This process is more relevant in infancy and early childhood.
D. Reaction formation is a defense mechanism where an individual behaves in a manner opposite to their true feelings or impulses. In this scenario, the client's expression of hatred towards the nurse does not appear to be a case of reaction formation, as there is no indication that the client actually harbors feelings of care or admiration towards the nurse.

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A client with borderline personality disorder reported to the nurse in the clinic that they feel empty and anxious and wants to cut their arms. The nurse should:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses that medication teaching about tricyclic antidepressants was understood when the client states:

Correct Answer is B

Explanation

The nurse has recently set limits for a client with borderline personality disorder. The client tells the nurse, "You used to care about me. I thought you were wonderful. Now I can see that I was mistaken. You are hateful." This outburst can be assessed as:

Correct Answer is C

Explanation

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