A nurse is assessing a client during a follow-up visit at a behavioral health clinic. The client reports that they have not been taking the prescribed antipsychotic medication on a regular basis. Which of the following actions should the nurse take to improve medication adherence?

Discuss the provider's goals for the client's care.

Ask the client if the medication is causing adverse effects.

Tell the client they will be admitted to an inpatient care facility if they do not take the medication.

Request the provider prescribe a second antipsychotic medication to the client.

Answer and Explanation

The Correct Answer is B

A. Discuss the provider's goals for the client's care:
Discussing the provider's goals is essential, but it may not directly address the client's concerns about medication adherence. While these goals are important for the overall care plan, it's crucial to first engage in a conversation with the client about their specific issues and challenges related to taking the prescribed medication. The client's perspective and concerns should be a priority.

B. Ask the client if the medication is causing adverse effects:
This is the recommended choice. Inquiring about adverse effects is important to understand the client's experience with the medication. Some clients may discontinue their medication due to intolerable side effects. By addressing this concern, the nurse can provide education, seek potential solutions, and collaborate with the healthcare team to adjust the medication or dosage. Open communication helps to identify and mitigate barriers to medication adherence.

C. Tell the client they will be admitted to an inpatient care facility if they do not take the medication:
This choice involves a coercive and threatening approach. It's not an ethical or therapeutic method to promote medication adherence. Threatening involuntary hospitalization can create fear and mistrust, potentially leading to further non-compliance and damaging the therapeutic relationship. It should be avoided.

D. Request the provider prescribe a second antipsychotic medication to the client:
This option is not appropriate at this stage. Adding another medication without addressing the underlying issue of non-adherence and without assessing the client's response to the current medication is not advisable. It can complicate the medication regimen, potentially worsen side effects, and doesn't address the primary concern, which is the client's non-adherence to their current medication. It's important to understand the reasons for non-adherence before considering additional medications.

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Correct Answer is D

Explanation

A. Denial:
Denial is a defense mechanism in which a person refuses to accept reality or acknowledge the existence of something that is evident to others. For example, a person diagnosed with a serious illness might deny that they are ill or refuse to believe the diagnosis. In this scenario, the client is not denying a reality; he is expressing anger and directing it toward the nurse.

B. Compensation:
Compensation is a defense mechanism where an individual overachieves in one area to compensate for real or imagined deficiencies in another area. For instance, someone who feels intellectually inferior might excel in sports to compensate for their perceived inadequacy. This is not applicable to the client's situation in the scenario provided.

C. Rationalization:
Rationalization involves providing logical or reasonable explanations to justify behaviors or feelings that might otherwise be unacceptable. For instance, a person might rationalize a failure by blaming external factors rather than accepting personal responsibility. In the scenario, the client is not offering rationalizations but is expressing direct anger.

D. Displacement:
Displacement occurs when emotions, especially anger or frustration, are redirected from the original source to a less threatening target. For example, a person who is angry with their boss might come home and take out their frustration on their family members. In the given situation, the client is displacing his anger from his partner onto the nurse, asking her to leave, making displacement the most appropriate choice.

A. The client follows a strict routine of daily activities. B. The client reports having a substance use disorder. C. The client is a twin D. The client's mother abandoned him as a child. E. The client's father has an impulse control disorder.

Correct Answer is ["B","D","E"]

Explanation

A. The client follows a strict routine of daily activities:
This choice is less likely to be a risk factor for borderline personality disorder. BPD is characterized by impulsivity and difficulties in maintaining stable routines or relationships. Individuals with BPD often struggle with adhering to strict routines due to impulsive behaviors and emotional dysregulation.

B. The client reports having a substance use disorder:
Individuals with borderline personality disorder often struggle with impulse control and emotional regulation. Substance use can be a way for them to cope with intense emotions and mood swings. The presence of a substance use disorder can indicate a higher risk for borderline personality disorder due to these coping mechanisms.

C. The client is a twin:
Being a twin, in itself, is not a direct risk factor for borderline personality disorder. However, if there are genetic or environmental factors contributing to the disorder, both twins might be at risk due to shared genetic material and upbringing. It's essential to consider the specific familial and environmental context when assessing the risk in twins.

D. The client's mother abandoned him as a child:
Early childhood experiences play a significant role in the development of personality disorders, including borderline personality disorder. Abandonment, neglect, or other forms of trauma can disrupt a child's sense of security and trust, leading to difficulties in regulating emotions and forming stable relationships later in life.

E. The client's father has an impulse control disorder:
Growing up in an environment where a parent has an impulse control disorder can create an unstable living situation. Inconsistent parenting and unpredictable behaviors can contribute to emotional instability and difficulties in regulating impulses, which are hallmark features of borderline personality disorder.

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A nurse is assessing a client during a follow-up visit at a behavioral health clinic. The client reports that they have not been taking the prescribed antipsychotic medication on a regular basis. Which of the following actions should the nurse take to improve medication adherence?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating?

Correct Answer is D

Explanation

A nurse is reviewing the medical record of a young adult client who has a new diagnosis of borderline personality disorder. Which of the following findings should the nurse identify as risk factors for this disorder? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

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