When a client with a personality disorder uses self-destructive behavior as a way of getting needs met, the staff observe the behavior closely because:

It is required to ensure the safety of the client and others.

It indulges the client’s wishes.

It provides an outlet for feelings of anger and frustration.

The client’s anger and anxiety will be decreased if staff assume responsibility for the client’s behavior.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

When a client with a personality disorder engages in self-destructive behavior, it is crucial for the staff to observe this behavior closely to ensure the safety of both the client and others around them. Self-destructive behaviors can include actions such as self-harm, substance abuse, or reckless activities that pose a significant risk to the individual’s well-being. By monitoring these behaviors, staff can intervene promptly to prevent harm and provide necessary support. Ensuring safety is a fundamental aspect of care in mental health settings, as it helps to stabilize the client and create a secure environment for their treatment and recover.

Choice B Reason:

Indulging the client’s wishes is not a recommended approach when dealing with self-destructive behavior. While it is important to understand and validate the client’s feelings, indulging their wishes can reinforce negative behaviors and hinder their progress towards healthier coping mechanisms. Instead, staff should focus on providing appropriate interventions and support that address the underlying issues contributing to the self-destructive behavior. This approach helps the client develop more constructive ways of meeting their needs and managing their emotions.

Choice C Reason:

While self-destructive behavior may provide a temporary outlet for feelings of anger and frustration, it is not a healthy or sustainable way to cope with these emotions. Encouraging or allowing such behavior can lead to further harm and exacerbate the client’s mental health issues. Staff should work with the client to identify and implement healthier coping strategies that effectively address their emotional needs without causing harm. This can include therapeutic interventions, counseling, and skills training to help the client manage their anger and frustration in more constructive ways.

Choice D Reason:

Assuming responsibility for the client’s behavior is not an effective way to reduce their anger and anxiety. In fact, it can create a dependency on staff and prevent the client from developing their own coping skills and sense of autonomy. It is important for staff to support the client in taking responsibility for their actions and learning how to manage their emotions independently. This empowerment is a key component of the therapeutic process and contributes to the client’s long-term recovery and well-being.

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Correct Answer is B

Explanation

Choice A Reason:

Promoting activities that encourage self-reflection. While promoting self-reflection is important in the therapeutic process, it is not the most essential aspect initially for establishing a trusting nurse-patient relationship. Self-reflection activities are more effective once a foundation of trust has been established.

Choice B Reason:

Conveying an accepting attitude. This statement is correct. Conveying an accepting attitude is crucial in the initial stages of establishing a trusting nurse-patient relationship. Patients with borderline personality disorder often feel judged and misunderstood. An accepting attitude helps to create a safe and supportive environment, which is essential for building trust and encouraging open communication.

Choice C Reason:

Identifying community resources. Identifying community resources is important for long-term support and management of borderline personality disorder, but it is not the most essential aspect initially for establishing trust. This step is more relevant once the therapeutic relationship has been established and the patient is ready to engage with external support systems.

Choice D Reason:

Providing positive feedback. Providing positive feedback is beneficial in reinforcing positive behaviors and encouraging progress. However, it is not the most essential aspect initially for establishing trust. Positive feedback is more effective when the patient already feels understood and supported by the nurse.

A. Provide the daughter and client with nutritional counseling B. Request a psychiatric evaluation for the client C. Take the history from the daughter because of the client’s confusion D. Interview the client alone and assess for abuse

Correct Answer is D

Explanation

d. Interview the client alone and assess for abuse

Explanation of Choices

Choice A Reason: Provide the Daughter and Client with Nutritional Counseling

While nutritional counseling is important, especially given the client’s malnourished state, it is not the immediate priority in this scenario. The client’s reluctance to speak and the daughter’s interruptions suggest that there may be underlying issues that need to be addressed first. Nutritional counseling can be provided later, once the immediate concerns have been resolved.

Choice B Reason: Request a Psychiatric Evaluation for the Client

Requesting a psychiatric evaluation may be necessary if there are signs of mental health issues, but it is not the first step in this situation. The priority is to ensure the client’s safety and well-being by addressing any immediate concerns, such as potential abuse. A psychiatric evaluation can be considered after the initial assessment and intervention.

Choice C Reason: Take the History from the Daughter Because of the Client’s Confusion

Taking the history from the daughter might seem practical due to the client’s confusion, but it is not the best approach in this case. The daughter’s constant interruptions and the client’s reluctance to speak raise concerns about the reliability of the information provided by the daughter. It is crucial to gather information directly from the client whenever possible to ensure an accurate assessment.

Choice D Reason: Interview the Client Alone and Assess for Abuse

Interviewing the client alone and assessing for abuse is the most appropriate intervention. The client’s reluctance to speak and the daughter’s interruptions could indicate that the client is being controlled or intimidated. Conducting a private interview allows the client to speak freely and provides an opportunity to identify any signs of abuse or neglect. Ensuring the client’s safety and addressing any immediate risks is the top priority.

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When a client with a personality disorder uses self-destructive behavior as a way of getting needs met, the staff observe the behavior closely because:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is D

Explanation

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