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 D

Explanation

A. "Don't worry about it. Your anxiety will lessen once the massage begins."
This response dismisses the client's concerns and may not be respectful of their boundaries. It does not acknowledge the client's discomfort and does not offer a solution to address their preference.

B. "Why don't you like to be touched by others?"
While the nurse is attempting to understand the client's feelings, this question might come across as invasive or judgmental. The client may not feel comfortable discussing their reasons for not liking to be touched, and this response does not offer an immediate solution to the issue at hand.

C. "I will request that the massage therapist wear gloves during your treatment."
This response shows an attempt to accommodate the client's preference by suggesting a practical solution, such as wearing gloves to create a physical barrier. However, it's important to note that some individuals may still find this uncomfortable, and it might not be a universally effective solution for everyone.

D. "I will tell your provider that you would like a treatment other than massage."
This response acknowledges the client's discomfort and demonstrates respect for their boundaries. It indicates the nurse's intention to advocate for the client's preferences and well-being. By informing the provider about the client's aversion to touch, the nurse opens the door to exploring alternative treatment options that are more suitable for the client's comfort level.

A. "What have you done to change your situation?" B. "You should remove yourself from this situation now." C. “Are you thinking about harming yourself?" D. “We will help get you through this. You'll be fine."

Correct Answer is C

Explanation

A. "What have you done to change your situation?"
This response can come off as accusatory and might make the client feel judged. It's not the most therapeutic response in this situation.

B. "You should remove yourself from this situation now."
While removing oneself from a harmful situation is generally good advice, it might not be practical or safe in the heat of the moment. Moreover, this response doesn't address the underlying emotional distress the client is expressing.

C. “Are you thinking about harming yourself?"
This response directly assesses the client's suicidal ideation. It's essential to ask direct questions about self-harm when a person expresses feelings of hopelessness, as it provides an opportunity for the client to talk about their thoughts and feelings and for the nurse to assess the level of risk accurately.

D. “We will help get you through this. You'll be fine."
While offering support and reassurance is essential, it doesn't directly address the immediate concern of potential suicidal thoughts. The nurse should assess the client's safety first before providing reassurance.

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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.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is prescribed massage therapy to treat panic disorder. The client states, "I can't stand to be touched by another person." Which of the following responses should the nurse make?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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