A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of post-traumatic stress disorder? (Select all that apply)

Choice A reason: Obtaining initial assessments requires clinical judgment and is outside the scope of assistive personnel (AP). Registered nurses must perform assessments to identify health changes accurately. Delegating this task violates scope of practice regulations, making it illegal and unsafe for AP to perform.
Choice B reason: Changing a nonsterile dressing is within the scope of assistive personnel, as it involves routine, non-invasive care under nurse supervision. AP are trained for such tasks, which do not require clinical judgment, making this a legal and appropriate delegation choice.
Choice C reason: Interpreting laboratory results requires advanced knowledge and clinical decision-making, reserved for registered nurses or providers. Assistive personnel lack the training to analyze results, so delegating this task is illegal and risks patient safety, making it an incorrect choice.
Choice D reason: Educating clients and families involves assessing learning needs and tailoring information, which requires nursing judgment. Assistive personnel are not trained for patient education, making this task outside their scope and illegal to delegate, thus an incorrect choice.

Choice A reason: Clients with borderline personality disorder (BPD) typically exhibit an unstable sense of self and tumultuous relationships, not stability. Their identity disturbances and fear of abandonment lead to chaotic interpersonal dynamics, making this statement incorrect as it misrepresents core BPD characteristics.
Choice B reason: Self-harming behaviors, such as cutting or suicidal gestures, are common in BPD due to emotional dysregulation and impulsivity. These actions serve as maladaptive coping mechanisms for intense emotions, aligning with DSM-5 criteria for BPD, making this the correct information to include.
Choice C reason: While group therapy can be beneficial, dialectical behavior therapy (DBT), an individual and skills-based approach, is the primary evidence-based treatment for BPD. Group therapy alone is not the standard, as it may not address individual emotional regulation needs, making this statement inaccurate.
Choice D reason: Clients with BPD frequently experience mood swings and emotional instability, a hallmark of the disorder due to affective dysregulation. This contradicts the statement, as BPD involves rapid mood shifts, not stability, making this information incorrect for describing BPD characteristics.