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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A rationale:

The client’s reported behavior of using laxatives and inducing vomiting after eating can lead to a condition known as hypomagnesemia. Hypomagnesemia is a condition characterized by low levels of magnesium in the blood. This condition can be caused by poor intake, excessive loss, or movement of magnesium from the blood into less accessible locations. The use of laxatives can lead to excessive loss of magnesium through increased bowel movements. Similarly, self-induced vomiting can also result in a loss of magnesium. Therefore, the client’s behavior puts them at risk for developing hypomagnesemia.

Choice B rationale:

Renal failure, also known as kidney failure, occurs when the kidneys lose their ability to filter waste products from the blood. While the use of laxatives and self-induced vomiting can lead to dehydration, which can strain the kidneys, these behaviors are not directly associated with renal failure. Therefore, while it’s possible for the client to develop kidney problems, it’s less likely compared to hypomagnesemia.

Choice C rationale:

Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. This condition can cause symptoms like shortness of breath, swelling, fatigue, and other symptoms. While severe electrolyte imbalances, such as those that might result from the use of laxatives and self-induced vomiting, can affect heart function, they would typically result in arrhythmias (irregular heartbeats) rather than heart failure. Therefore, it’s less likely for the client to develop heart failure based on the behaviors described.

Choice D rationale:

Hyperthyroidism is a condition where the thyroid gland produces and releases too much thyroid hormone. This condition can cause symptoms like rapid heartbeat, weight loss, and anxiety. The client’s behaviors of using laxatives and inducing vomiting after eating do not directly influence the production of thyroid hormones. Therefore, it’s less likely for the client to develop hyperthyroidism based on the behaviors described.

A. Increasing feelings of anger. B. Sleeping 12 hours or more each day. C. Increasing sense of attachment to others. D. Constant need to talk about the event.

Correct Answer is A

Explanation

Choice A rationale:

Anger is a common and expected response to trauma, including sexual assault. It can stem from various sources, including:

Feelings of violation and powerlessness: Survivors may feel intense anger towards the perpetrator for taking control of their bodies and lives.

Betrayal: If the assault was committed by someone they knew or trusted, survivors may feel intense anger towards that person for breaking their trust.

Frustration and injustice: Survivors may feel angry at the injustice of the situation, the lack of control they had, and the ongoing impact of the trauma.

Difficulty processing other emotions: Anger can sometimes mask other emotions that are difficult to deal with, such as fear, sadness, or guilt.

Anger can manifest in various ways, including:

Irritability and outbursts: Survivors may have a short temper, snap at others easily, or have difficulty controlling their anger. Aggression: In some cases, anger can lead to physical or verbal aggression towards others or self-harming behaviors.

Withdrawal and isolation: Some survivors may withdraw from social interactions and relationships to avoid potential triggers for their anger.

Substance abuse: Some survivors may turn to alcohol or drugs to numb their feelings or cope with their anger.

Choice B rationale:

Sleeping 12 hours or more each day can be a symptom of PTSD, but it is not a specific indicator of anger. It can also be a sign of depression, anxiety, or hypersomnia, a sleep disorder characterized by excessive daytime sleepiness.

Choice C rationale:

PTSD can sometimes lead to an increased sense of detachment from others, rather than attachment. Survivors may feel emotionally numb, have difficulty trusting others, or withdraw from relationships.

Choice D rationale:

While some survivors of sexual assault may feel a need to talk about the event, it is not a universal symptom of PTSD. Some survivors may avoid talking about the event altogether due to the distress it causes.

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A nurse is planning discharge for a client who has borderline personality disorder. Which of the following interventions should be included for this client?

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