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A nurse in an outpatient mental health center is caring for a client.

Exhibits

For each potential assessment finding, click to specify if the finding is consistent with paranoid personality disorder or borderline personality disorder. Each finding may support more than 1 personality disorder or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

A.

Relationship status

B.

Concerns about Coworkers

C.

Client statement

D.

Skin alterations

E.

Behavior pattern

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A,B"}}

Rationale:

  • Relationship status: BPD is marked by instability in relationships, often due to intense fear of abandonment or difficulty managing emotional attachments. Sudden breakups or conflict with close partners are common, especially during emotional crises.
  • Concerns about coworkers: Individuals with PPD often misinterpret benign actions of others as malicious or threatening. Persistent beliefs that others are conspiring against them—despite little or no evidence—are core features of the disorder.
  • Client statement: Impulsivity is a diagnostic criterion for BPD. Risky behaviors like sudden, financially irresponsible purchases are driven by difficulty regulating emotion and can reflect an effort to escape negative feelings.
  • Skin alterations: Recurrent self-harm (e.g., superficial cutting) is a hallmark of BPD, typically used to cope with overwhelming emotional distress, feelings of emptiness, or perceived rejection or abandonment.
  • Behavior pattern: Blunted affect and lack of improvement may reflect emotional withdrawal seen in both BPD and PPD. In BPD, emotional dysregulation underlies these symptoms; in PPD, chronic mistrust can lead to guarded, affectively flat behavior and resistance to help.


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Related Questions

Correct Answer is D

Explanation

Rationale:

A. Encourage physical activity prior to bedtime: Stimulating activity close to bedtime can increase agitation and make it harder for clients with Alzheimer’s disease to settle for sleep. Calming routines in the evening are more appropriate to reduce nighttime confusion and restlessness.

B. Wear clothing with zippers instead of buttons: Although zippers are often easier than buttons, clients with Alzheimer’s may have difficulty with any fasteners. Simple clothing with Velcro or elastic waists is typically more suitable to promote independence.

C. Replace the carpet with hardwood floors: Carpets provide traction and cushioning, which can help prevent injuries from falls. Hardwood floors may be slippery or cause confusion due to glare or unfamiliar patterns, increasing fall risk.

D. Place locks at the tops of exterior doors: Clients with Alzheimer’s are at risk for wandering. Installing locks at the tops of doors—out of the client's usual line of sight—helps prevent elopement while preserving safety in the home environment.

Correct Answer is C

Explanation

Rationale:

A. Complete the feeding in 5 min: NG tube feedings should be administered slowly, typically over 20–30 minutes, to allow for proper digestion and to reduce the risk of nausea, vomiting, or aspiration in pediatric clients.

B. Warm the formula in the microwave: Microwaving can create uneven hot spots in the formula, risking oral or gastrointestinal burns. Formula should be warmed safely by placing the container in warm water and checking the temperature before administration.

C. Measure the tubing from the nose to the distal port: Correct NG tube placement is essential to prevent aspiration and ensure the feeding reaches the stomach. Measurement is done from the nose to the ear lobe and then to the xiphoid process (not the distal port), but this option reflects the importance of measurement as part of safe practice.

D. Position the child at a 10° to 20° angle after feeding: After NG feeding, the child should be kept in an upright position of at least 30° to 45° for 30–60 minutes to facilitate digestion and minimize aspiration risk. A 10° to 20° angle is too low and unsafe

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