A nurse is caring for a client who is unable to make any decisions for themselves and needs constant reassurance. The nurse should identify that these are manifestations of which of the following personality disorders?

Avoidant personality disorder

Borderline personality disorder

Dependent personality disorder

Schizoid personality disorder

Answer and Explanation

The Correct Answer is C

Choice A reason : Avoidant personality disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Individuals with this disorder may avoid work activities or decline job offers due to fears of criticism or rejection. However, they do not typically exhibit a need for constant reassurance or an inability to make decisions, which are more indicative of dependent personality disorder⁵⁶.

Choice B reason : Borderline personality disorder involves a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity. While individuals with borderline personality disorder may exhibit dependency traits, they are more likely to engage in frantic efforts to avoid real or imagined abandonment and may have a pattern of unstable and intense interpersonal relationships⁷⁸.

Choice C reason : Dependent personality disorder is characterized by a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior and fears of separation. Individuals with this disorder often require excessive advice and reassurance from others to make everyday decisions and may feel helpless when alone due to exaggerated fears of being unable to care for themselves. The need for constant reassurance and inability to make decisions align with the symptoms of dependent personality disorder¹²³⁴.

Choice D reason : Schizoid personality disorder is characterized by a lack of interest in social relationships, a tendency toward a solitary lifestyle, secretiveness, emotional coldness, detachment, and apathy. Individuals with schizoid personality disorder prefer to be alone and do not seek out social interactions or relationships. They do not typically display the need for reassurance or the inability to make decisions, as seen in dependent personality disorder¹²¹³¹⁴.

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Correct Answer is D

Explanation

Choice A reason : Elevating the head of the bed to 20 degrees can help reduce intracranial pressure by promoting venous drainage from the brain. It is a recommended practice unless contraindicated by other conditions³.

Choice B reason : Cleansing the eyes with normal saline every 4 hours is a standard care procedure to maintain eye hygiene and prevent infection, especially when the blink reflex may be compromised in an unconscious patient³.

Choice C reason : Lubricating the skin with baby oil is a common practice to prevent dryness and maintain skin integrity. It is not contraindicated unless the patient has specific allergies or skin conditions that require different care³.

Choice D reason : Suctioning the oropharynx routinely is contraindicated as it can stimulate the vagus nerve and potentially increase intracranial pressure. Suctioning should be performed cautiously and only when necessary³.

A. Avoid exercise during flare-ups. B. Establish a regular sleep pattern. C. Increase calcium intake. D. Engage in yoga or running between flare-ups.

Correct Answer is B

Explanation

Choice A reason : Avoiding exercise during flare-ups of fibromyalgia may seem intuitive to prevent exacerbating pain and fatigue. However, maintaining a gentle exercise routine, even during flare-ups, can help manage symptoms and prevent deconditioning¹.

Choice B reason : Establishing a regular sleep pattern is crucial for managing fibromyalgia. Poor sleep can exacerbate pain, fatigue, and cognitive difficulties commonly experienced with this condition. Good sleep hygiene practices can improve sleep quality and overall symptom management¹.

Choice C reason : While adequate calcium intake is essential for general health, there is no specific indication that increasing calcium intake alone would manage fibromyalgia symptoms. Nutritional needs should be addressed as part of a comprehensive approach to self-care¹.

Choice D reason : Yoga or running between flare-ups can be beneficial for clients with fibromyalgia. Regular exercise, including yoga, can improve pain, function, and quality of life. Running or other aerobic exercises can also be helpful if tolerated and done in moderation¹.

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A nurse is caring for a client who is unable to make any decisions for themselves and needs constant reassurance. The nurse should identify that these are manifestations of which of the following personality disorders?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When caring for an unconscious client with increasing intracranial pressure, the nursing intervention that is contraindicated is :

Correct Answer is D

Explanation

A nurse is teaching a client who has fibromyalgia about self-care strategies for managing the disorder. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care?

A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values?

A nurse is providing teaching to a client who has a new prescription for tamoxifen to treat breast cancer. The nurse should include that which of the following is an adverse effect of this medication?

A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse that the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.)

A nurse is caring for a client who has reported experiencing abuse at home. Which of the following actions should be a priority for the nurse?

A client has undergone surgery for the creation of burr holes after sustaining head trauma from a fall and is at risk for developing an infection. An early critical manifestation of meningeal irritation for which the nurse assesses the client is :

A nurse is caring for a client who frequently attempts to remove his IV catheter. A family member requests that the nurse apply restraints. Which of the following responses should the nurse make?

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?