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A nurse is assisting with the care of a client and is collecting data from the client.

Exhibits

Select words from the choices below to fill in each blank in the following sentence.

The nurse should identify that

and indicate manifestations of borderline personality disorder
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}

The nurse should identify that emotional dysregulation and fear of abandonment indicate manifestations of borderline personality disorder. Emotional dysregulation is a hallmark of borderline personality disorder (BPD), characterized by intense and rapidly shifting emotions. Fear of abandonment is a core feature of BPD, leading to anxiety and distress over perceived or anticipated rejection by significant others.


A.    Tactile hallucinations: Tactile hallucinations refer to false perceptions of touch or physical sensations on the skin, which are not typically associated with borderline personality disorder. These hallucinations are more commonly associated with conditions like schizophrenia or substance-induced disorders.
B.    Emotional ability: Emotional dysregulation is a hallmark of borderline personality disorder (BPD). Individuals with BPD often experience intense and rapidly shifting emotions that can be triggered by seemingly minor events. This emotional volatility can lead to difficulties in interpersonal relationships and impulsive behaviors.
C.    Fear of abandonment: Fear of abandonment is a core feature of borderline personality disorder. Individuals with BPD often experience intense anxiety and distress when they perceive or anticipate rejection or abandonment by significant others. This fear can drive their behaviors, including efforts to prevent real or imagined abandonment.
D.    Elevated body temperature: Elevated body temperature is not a characteristic manifestation of borderline personality disorder. Instead, it may be associated with medical conditions such as infections or inflammatory processes.
E.    Increased heart: While emotional distress and anxiety are common in individuals with borderline personality disorder, "increased heart" is not a specific manifestation of the disorder. Anxiety and emotional distress can lead to physiological responses such as increased heart rate, but this is a general response rather than a defining characteristic of BPD.


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Related Questions

Correct Answer is B

Explanation

A.Restraints should be released more frequently, typically every 2 hours, to assess circulation, skin integrity, and range of motion, and to provide an opportunity for toileting and other needs.

B.It is essential to document the specific behaviors that led to the use of restraints, as this provides a clear rationale for why the restraints were necessary. This documentation is important for legal and clinical reasons and helps ensure that restraints are used appropriately and only when absolutely necessary.

C.Clients are not required to provide written consent for the use of restraints, especially in situations where restraints are necessary to protect the client or others from immediate harm. However, the nurse must follow the facility's protocol, which usually involves obtaining a physician's order and documenting the justification for the restraint use.

D.The nurse should check the client's status more frequently, typically every 15 minutes, to ensure the client's safety and well-being while in restraints.

Correct Answer is B

Explanation

A. "If you are allergic to gluten you should not receive this vaccine."Gluten allergy is not a contraindication for the MMR vaccine. The vaccine does not contain gluten, and an allergy to gluten would not prevent someone from safely receiving the vaccine. However, individuals with severe allergies to neomycin or gelatin (which are components of the vaccine) should not receive it.

B. "Avoid pregnancy for at least 28 days after receiving the vaccine."The MMR vaccine contains live attenuated viruses, and there is a theoretical risk to the fetus if a woman becomes pregnant shortly after vaccination. Therefore, it is recommended that women avoid becoming pregnant for at least 28 days after receiving the MMR vaccine to reduce any potential risks.

C. "Avoid breastfeeding for 3 days after receiving the vaccine."The MMR vaccine is safe for breastfeeding mothers and does not require any interruption in breastfeeding. The vaccine viruses are not transmitted through breast milk in a way that would harm the infant.

D. "Your partner should also receive the MMR vaccine."While it is important for all individuals to be up-to-date on their vaccinations, the partner's vaccination status is unrelated to the postpartum administration of the MMR vaccine to the client. This instruction does not address a specific concern related to the postpartum period or the MMR vaccine's administration at this time.

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