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 C

Explanation

d. Speaks another language and is in need of an interpreter to translate.

The correct answer is…

c. Is accompanied by a family member who will not let the client answer questions.

Choice A Reason:

The statement that the client is from another state and says they are here on a long vacation could be a sign of human trafficking, but it is not definitive. People often travel for various reasons, and being from another state does not necessarily indicate trafficking. However, if combined with other suspicious behaviors, it could raise concerns. Traffickers often move victims to different locations to avoid detection, but this alone is not enough to suspect trafficking.

Choice B Reason:

Having a cell phone that is not working in the emergency department might be suspicious, but it is not a strong indicator of human trafficking. There could be many reasons for a non-functioning cell phone, such as technical issues or lack of service. While traffickers might control victims’ communication devices, this alone does not provide enough evidence to suspect trafficking.

Choice C Reason:

Being accompanied by a family member who will not let the client answer questions is a strong indicator of human trafficking. Traffickers often pose as family members or friends to maintain control over their victims and prevent them from speaking freely. This behavior is a red flag because it suggests that the accompanying person is trying to control the interaction and possibly hide something. Healthcare providers are trained to recognize this as a potential sign of trafficking.

Choice D Reason:

Speaking another language and needing an interpreter to translate is not a strong indicator of human trafficking. Many people who are not victims of trafficking may speak different languages and require translation services. While language barriers can complicate communication, they are not in themselves indicative of trafficking. However, if combined with other suspicious behaviors, it could contribute to the overall assessment.

A. The client’s behavioral change is expected after the time period of medication. B. The client may have worked out details of their suicide plan. C. The medication dosage should be decreased and a mood stabilizer added. D. The medication has potentiated serotonin syndrome.

Correct Answer is A

Explanation

The correct answer is a. The client’s behavioral change is expected after the time period of medication.

Choice A Reason:

This choice is correct because fluoxetine, a selective serotonin reuptake inhibitor (SSRI), typically takes about 4 to 6 weeks to start showing its full effects. The client’s statement, “I feel like a great weight is off my chest,” indicates a positive response to the medication, which aligns with the expected timeline for SSRIs to improve mood and alleviate symptoms of depression. This behavioral change suggests that the medication is working as intended, helping to lift the depressive symptoms.

Choice B Reason:

This choice is incorrect and concerning. While it is true that some individuals may experience a temporary increase in energy before their mood improves, which could potentially increase the risk of suicide, the client’s positive statement does not necessarily indicate suicidal planning. It is important for healthcare providers to continuously monitor for any signs of suicidal ideation, but in this context, the client’s statement more likely reflects an improvement in their depressive symptoms.

Choice C Reason:

This choice is incorrect because there is no indication that the medication dosage should be decreased or that a mood stabilizer should be added. Fluoxetine is generally well-tolerated, and the client’s positive response suggests that the current dosage is effective. Mood stabilizers are typically used in the treatment of bipolar disorder, not major depressive disorder, unless there is a specific indication for their use.

Choice D Reason:

This choice is incorrect and indicates a misunderstanding of serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin activity in the brain, often due to drug interactions or overdose. Symptoms include agitation, confusion, rapid heart rate, and high blood pressure4. The client’s statement of feeling relieved does not align with the symptoms of serotonin syndrome, which are generally severe and require immediate medical attention.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who is malnourished and appears exhausted. What data would cause the nurse to suspect the client is a victim of human trafficking? The client:

Correct Answer is C

Explanation

A client with major depressive disorder has been taking fluoxetine, an SSRI, for 5 weeks. During the first outpatient visit, the client smiles and states, “I feel like a great weight is off my chest.” How should the nurse interpret this behavior change?

Correct Answer is A

Explanation

Edited TextA client with borderline personality disorder reported to the nurse in the clinic that they feel empty and anxious. The client wants to cut their arms. The nurse should first:

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