A nurse is planning discharge for a client who has borderline personality disorder. Which of the following interventions should be included for this client?
Behavioral contract
Dialectical behavior therapy
Safety plan
Bibliotherapy.
The Correct Answer is B
The correct answer is choice B.
Choice A rationale:
“Behavioral contract.” While a behavioral contract can be a useful tool in managing certain behaviors, it is not typically the primary intervention used in the discharge planning for a client with borderline personality disorder.
Choice B rationale:
“Dialectical behavior therapy.” This is the correct answer. Dialectical behavior therapy (DBT) is a type of cognitive-behavioral therapy that is specifically designed to help people with borderline personality disorder. It focuses on teaching coping skills to combat destructive urges, encourages mindfulness, improves relationships, and helps with emotional regulation.
Choice C rationale:
“Safety plan.” While a safety plan is important for all clients, it is not the primary intervention for a client with borderline personality disorder. A safety plan is more commonly used for clients who are at risk of self-harm or suicide.
Choice D rationale:
“Bibliotherapy.” Bibliotherapy, the use of books as therapy, can be a useful adjunctive treatment for some individuals. However, it is not typically the primary intervention used in the discharge planning for a client with borderline personality disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale: Expression of guilt feelings is a positive outcome in the treatment of conduct disorder. Guilt is an emotional response to one’s actions that are perceived as wrong or inappropriate. It is a self-conscious emotion that often involves a
sense of tension and regret. In the context of conduct disorder, the expression of guilt feelings can be seen as a sign of developing empathy and understanding the consequences of one’s actions. This is a crucial step in the process of behavior change and rehabilitation. The client showing signs of remorse during one-on-one counseling is a positive sign indicating that the treatment is having an effect.
Choice B rationale: A statement regarding unit rules is another positive outcome in the treatment of conduct disorder. Understanding and acknowledging the rules of the unit indicates that the client is beginning to accept the boundaries and norms set by the authority. This is a significant step towards improving their behavior, as individuals with conduct disorder often have difficulties following rules and respecting authority. The verbal altercation with another client could be seen as a negative event, but it also could indicate that the client is engaging with others, which could be a step towards improvement, depending on the context of the altercation.
Choice C rationale: A renewed relationship with an uncle does not necessarily indicate a positive outcome from the treatment of conduct disorder. While family support can be beneficial in the treatment process, it does not directly indicate that the client’s conduct disorder is improving. More information would be needed to determine if this is a positive outcome related to the treatment.
Choice D rationale: A positive attitude toward school is a positive outcome in the treatment of conduct disorder. School is a structured environment where rules and expectations are clearly laid out, and a positive attitude towards school can indicate that the client is beginning to accept these structures. This can be a sign of improvement in their behavior and attitude.
Correct Answer is D
Explanation
Choice A rationale:
Deflecting the client's concerns to the physician dismisses the client's immediate need for emotional support and therapeutic communication.
It can hinder the development of a trusting nurse-client relationship.
The nurse is responsible for addressing the client's psychosocial needs, not solely deferring them to other healthcare professionals.
Choice B rationale:
Offering false reassurance is inappropriate and potentially harmful. It can erode trust if the client's fears are later realized.
It minimizes the client's legitimate concerns and invalidates their emotional experience.
Choice C rationale:
While lifestyle modifications are essential for managing coronary artery disease, providing unsolicited advice at this moment disregards the client's emotional distress.
It prioritizes physical health over the client's psychological well-being. It can be perceived as dismissive of the client's fears and concerns.
Choice D rationale:
Inviting the client to elaborate on their fears demonstrates active listening and encourages therapeutic communication. It validates the client's concerns and shows empathy for their emotional experience.
It provides an opportunity to assess the client's understanding of their condition and identify specific fears or misconceptions. It establishes a foundation for exploring coping mechanisms and providing appropriate support and education.
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