A nurse is reviewing the medical record of a young adult client who has a new diagnosis of borderline personality disorder. Which of the following findings should the nurse identify as risk factors for this disorder? (Select all that apply.)

The client follows a strict routine of daily activities.

The client reports having a substance use disorder.

The client is a twin

The client's mother abandoned him as a child.

The client's father has an impulse control disorder.

Answer and Explanation

Correct Answer : B,D,E

A. The client follows a strict routine of daily activities:
This choice is less likely to be a risk factor for borderline personality disorder. BPD is characterized by impulsivity and difficulties in maintaining stable routines or relationships. Individuals with BPD often struggle with adhering to strict routines due to impulsive behaviors and emotional dysregulation.

B. The client reports having a substance use disorder:
Individuals with borderline personality disorder often struggle with impulse control and emotional regulation. Substance use can be a way for them to cope with intense emotions and mood swings. The presence of a substance use disorder can indicate a higher risk for borderline personality disorder due to these coping mechanisms.

C. The client is a twin:
Being a twin, in itself, is not a direct risk factor for borderline personality disorder. However, if there are genetic or environmental factors contributing to the disorder, both twins might be at risk due to shared genetic material and upbringing. It's essential to consider the specific familial and environmental context when assessing the risk in twins.

D. The client's mother abandoned him as a child:
Early childhood experiences play a significant role in the development of personality disorders, including borderline personality disorder. Abandonment, neglect, or other forms of trauma can disrupt a child's sense of security and trust, leading to difficulties in regulating emotions and forming stable relationships later in life.

E. The client's father has an impulse control disorder:
Growing up in an environment where a parent has an impulse control disorder can create an unstable living situation. Inconsistent parenting and unpredictable behaviors can contribute to emotional instability and difficulties in regulating impulses, which are hallmark features of borderline personality disorder.

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Correct Answer is C

Explanation

A. Liraglutide 0.6 mg subcutaneously daily:
Liraglutide is a medication used to treat type 2 diabetes and obesity. It works by regulating blood sugar levels and reducing appetite. It has no direct relevance to the treatment of schizophrenia or psychosis. Schizophrenia is a mental health disorder, and antipsychotic medications are typically used to manage its symptoms.

B. Selegiline 6 mg transdermal patch daily:
Selegiline is primarily used to treat Parkinson's disease by enhancing the effects of dopamine in the brain. It is not indicated for schizophrenia or psychosis. While dopamine dysregulation is involved in both Parkinson's disease and schizophrenia, the mechanisms and treatments are different. Antipsychotic medications, not selegiline, are used to manage psychosis in schizophrenia.

C. Aripiprazole 400 mg IM every 4 weeks:
This is the correct choice. Aripiprazole is an atypical antipsychotic medication commonly used to treat schizophrenia and other psychotic disorders. The intramuscular (IM) formulation provides extended release, making it suitable for clients who may have difficulty adhering to daily oral medications. It helps manage psychosis, a common symptom of schizophrenia.

D. Lithium 600 mg PO three times per day:
Lithium is a mood stabilizer commonly used to treat bipolar disorder by preventing or reducing the intensity of manic episodes. It is not a first-line treatment for schizophrenia or psychosis. Antipsychotic medications are the primary choice for managing the symptoms of psychosis in schizophrenia. Lithium is not typically used to address the hallucinations and delusions associated with schizophrenia.

A. “I will learn how to voluntarily control my blood pressure and heart rate." B. "I will practice replacing negative thoughts with positive self-statements." C. “I will focus on a mental image while concentrating on my breathing." D. "I will progressively relax each of my muscle groups when feeling stressed."

Correct Answer is B

Explanation

A. "I will learn how to voluntarily control my blood pressure and heart rate."
This statement indicates the client might be referring to techniques such as biofeedback or relaxation exercises that involve controlling physiological responses consciously. While these are relaxation techniques, they are not specifically cognitive reframing. Cognitive reframing focuses on changing negative thought patterns.

B. "I will practice replacing negative thoughts with positive self-statements."
This statement accurately reflects the concept of cognitive reframing. It involves identifying negative or unhelpful thoughts and consciously replacing them with positive, empowering, or rational thoughts. This technique is widely used in cognitive-behavioral therapy (CBT) to help individuals manage stress, anxiety, and various mental health issues.

C. "I will focus on a mental image while concentrating on my breathing."
This statement describes a relaxation technique where individuals visualize a calming image and synchronize their breathing with this mental image. While this practice is beneficial for relaxation, it is not cognitive reframing. Cognitive reframing specifically deals with changing the content of thoughts, not necessarily focusing on mental imagery.

D. "I will progressively relax each of my muscle groups when feeling stressed."
This statement describes a relaxation technique known as progressive muscle relaxation. It involves tensing and then relaxing different muscle groups to reduce physical tension and stress. While this technique is excellent for relaxation, it is not cognitive reframing. Cognitive reframing pertains to changing thoughts, not physical sensations.

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A nurse is reviewing the medical record of a young adult client who has a new diagnosis of borderline personality disorder. Which of the following findings should the nurse identify as risk factors for this disorder? (Select all that apply.)

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Correct Answer is B

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