A nurse is caring for a client who has borderline personality disorder. Which of the following outcomes should the nurse include in the treatment plan?

Choice A reason: While attending support group meetings can be beneficial for individuals with borderline personality disorder by providing a sense of community and shared experiences, it is not the immediate priority. Support groups can offer emotional support and coping strategies, but they do not directly address the urgent safety concerns that may arise with this disorder.

Choice B reason: Discussing the use of assertive behavior is an important aspect of therapy for individuals with borderline personality disorder, as it can help them express their needs and feelings in a healthy way. However, this is part of a long-term strategy for improving interpersonal relationships and communication skills, rather than an immediate safety concern.

Choice C reason: Implementing measures to prevent intentional self-inflicted injury is the priority when planning care for a client with borderline personality disorder. Due to the high risk of self-harm and suicidal behaviors associated with this disorder, ensuring the client's safety is the most critical and immediate concern. This may include creating a safe environment, developing a crisis plan, and closely monitoring the client.

Choice D reason: Assisting the client to maintain awareness of their thoughts and feelings is a key component of therapy for borderline personality disorder, as it can help them understand and manage their emotions more effectively. However, while this is important for long-term management, it is not the immediate priority when compared to ensuring the client's safety.

Choice A reason: Assertiveness training is typically used to help individuals communicate more effectively and assert their needs and rights while respecting others. However, for someone with narcissistic personality disorder (NPD), this approach may not address the core issues of grandiosity and lack of empathy.

Choice B reason: Response prevention therapy is often used in the treatment of obsessive-compulsive disorder to help prevent the individual from engaging in compulsive behaviors. It is not typically indicated for NPD, as it does not address the underlying issues of self-esteem and empathy.

Choice C reason: Schema-focused therapy is designed to help individuals with NPD by identifying and changing deeply ingrained patterns of thinking and behavior, known as schemas, that are often maladaptive. This therapy can help address the root causes of NPD, such as feelings of inadequacy and the need for admiration, making it a suitable recommendation for someone with NPD³.

Choice D reason: Cognitive behavioral therapy (CBT) can be effective for a range of mental health disorders by helping individuals recognize and change negative thought patterns. While CBT can be beneficial for someone with NPD, schema-focused therapy is often preferred because it goes deeper into the personality structure and addresses the specific challenges of NPD³.