A nurse is contributing to the plan of care for a client who has borderline personality disorder.
Which of the following interventions should the nurse recommend?
Encourage the client to communicate with staff when feeling urges for self-harm.
Assist the client in developing healthy coping mechanisms for intense emotions.
Advise the client to avoid expressing their feelings assertively.
Offer the client additional attention only when self-mutilating behaviors occur.
Correct Answer : A,B
Choice A rationale
Encouraging communication with staff during self-harm urges is a crucial intervention for clients with borderline personality disorder. This allows for immediate support, redirection of focus, and the opportunity to implement coping strategies before an episode of self-harm occurs, aligning with the principles of dialectical behavior therapy often used for this disorder.
Choice B rationale
Assisting the client in developing healthy coping mechanisms for intense emotions is fundamental in managing borderline personality disorder. Individuals with this disorder often experience emotional dysregulation, and learning adaptive coping skills provides them with tools to manage distress, reduce impulsivity, and decrease the likelihood of self-harm.
Choice C rationale
Advising the client to avoid expressing feelings assertively is countertherapeutic. Clients with borderline personality disorder may struggle with expressing emotions appropriately. Encouraging avoidance can lead to suppressed feelings, potential emotional outbursts, and increased risk of self-harm. Assertive communication skills should be fostered.
Choice D rationale
Offering additional attention only when self-mutilating behaviors occur can inadvertently reinforce these behaviors. This approach can create a pattern where the client engages in self-harm to gain attention, rather than learning healthier ways to seek support and manage their emotions. Consistent and proactive support is more effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Directly contradicting the client's hallucination by stating "I'm using a syringe to obtain your blood, not a snake" dismisses their experience and does not address their fear or distress. This can erode trust and make the client feel unheard.
Choice B rationale
Acknowledging the client's perception ("I don't see a snake") while validating their feelings ("that must be scary for you") is a therapeutic response. It shows empathy and helps the client feel understood without confirming the hallucination as real.
Choice C rationale
Telling the client "You must be mistaken. Snakes cannot be in the clinic" is dismissive and invalidates their sensory experience. Hallucinations are real to the person experiencing them, and denying their reality can be counterproductive.
Choice D rationale
Stating "Your provider requires this blood specimen" provides a factual explanation for the procedure but does not address the client's immediate fear and anxiety related to the hallucination. It prioritizes the task over the client's emotional state. .
Correct Answer is C
Explanation
Choice A rationale
Aripiprazole is an atypical antipsychotic medication primarily used to treat schizophrenia and bipolar disorder. It is not indicated for smoking cessation. While some individuals with mental health conditions also smoke, aripiprazole does not directly address nicotine dependence.
Choice B rationale
Quetiapine is another atypical antipsychotic medication used for the treatment of schizophrenia and bipolar disorder. Similar to aripiprazole, it does not have pharmacological properties that aid in smoking cessation.
Choice C rationale
Bupropion is an atypical antidepressant that has also been approved for smoking cessation. It is thought to work by affecting dopamine and norepinephrine levels in the brain, which are involved in nicotine addiction and withdrawal symptoms.
Choice D rationale
Risperidone is an atypical antipsychotic medication used to treat psychotic disorders. It does not have any known efficacy in aiding smoking cessation.
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