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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 A

Explanation

Rationale:

A. "Can you talk about what was happening with your partner at home?": This open-ended question encourages the partner to express emotions and provide context, which helps build trust and gather relevant information. It’s a therapeutic response that validates the partner’s experience without judgment or assumptions.

B. "Why do you think your partner's symptoms are progressing so quickly?” This question may come off as accusatory or put the partner on the defensive. "Why" questions can create a sense of blame or pressure, which is not conducive to a supportive therapeutic environment.

C. "You should make sure your partner takes the prescribed medication”: This directive may be perceived as dismissive and does not acknowledge the partner’s emotional distress. While medication adherence is important, this is not the most therapeutic or empathetic initial response.

D. "You did the right thing by bringing your partner in for treatment”: While affirming the decision is supportive, this response closes the conversation and doesn’t invite the partner to explore their concerns or emotions further, limiting therapeutic dialogue.

Correct Answer is A

Explanation

Rationale:

A. The client is tolerating clear liquids: After gastric banding, clients typically start with clear liquids within the first 24–48 hours. Tolerating clear liquids at 36 hours post-op is an expected and desired outcome that indicates gastrointestinal recovery and readiness to progress the diet gradually.

B. The client is voiding at least 250 mL/hr: This urine output is abnormally high and could indicate diuresis or overhydration. The expected minimum urine output is around 30 mL/hr, so this value exceeds normal expectations and is not typical postoperatively.

C. The client is maintaining bed rest: Early ambulation is encouraged after bariatric procedures to prevent complications such as deep vein thrombosis or pulmonary embolism. Prolonged bed rest is not expected or recommended.

D. The client is consuming 1,000 calories daily: At 36 hours post-op, clients are still on a very restricted intake—usually clear liquids or small sips—and would not be consuming 1,000 calories. This intake would be excessive and inappropriate at this stage of recovery.

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