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

Conduct Disorder

Choice A Reason: Childhood Depression

Childhood depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities. Symptoms can include changes in appetite, sleep disturbances, and difficulty concentrating. While depression can lead to behavioral issues, it is less likely to be associated with the specific behaviors described in the scenario, such as running away and being abusive towards parents. These behaviors are more indicative of a disruptive behavior disorder rather than a mood disorder.

Choice B Reason: Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is characterized by a pattern of angry, irritable mood, argumentative/defiant behavior, or vindictiveness. Children with ODD often lose their temper, argue with adults, and refuse to comply with rules. While ODD can involve some of the behaviors described, such as being abusive towards parents, it typically does not include the more severe behaviors like running away or engaging in illegal activities such as prostitution. Therefore, ODD is not the most fitting diagnosis in this case.

Choice C Reason: Conduct Disorder

Conduct Disorder is a more severe behavioral disorder characterized by a repetitive and persistent pattern of behavior that violates the rights of others or major age-appropriate societal norms or rules. Symptoms include aggression towards people and animals, destruction of property, deceitfulness or theft, and serious violations of rules, such as running away from home and engaging in illegal activities like prostitution. Given the behaviors described in the scenario, Conduct Disorder is the most appropriate diagnosis. Adolescents with Conduct Disorder often exhibit a lack of remorse or guilt and may have a history of problematic behaviors that escalate over time.

Choice D Reason: Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulties with social interaction, communication, and repetitive behaviors. While individuals with ASD may exhibit challenging behaviors, these are typically related to difficulties in understanding social norms and communication rather than intentional defiance or rule-breaking. The behaviors described in the scenario, such as running away and engaging in prostitution, are not characteristic of ASD, making it an unlikely diagnosis in this context.

A. Strong negative feelings interfere with assessment and judgment. B. Awareness protects one’s own mental health. C. Positive feelings promote the development of sympathy for clients. D. Strong positive feelings lead to underinvolvement with the victim.

Correct Answer is A

Explanation

Choice A Reason:

Strong negative feelings interfere with assessment and judgment.

This statement is the most accurate explanation for why a nurse needs to be aware of their own feelings while working with a family experiencing domestic violence. Negative emotions such as anger, frustration, or sadness can cloud a nurse’s judgment and hinder their ability to objectively assess the situation. These feelings can lead to biased decision-making, which may compromise the quality of care provided to the victim. For instance, a nurse who feels anger towards the abuser might unconsciously project these feelings onto the victim, affecting their ability to offer unbiased support and intervention. Therefore, maintaining emotional awareness is crucial for ensuring accurate assessments and effective interventions.

Choice B Reason:

Awareness protects one’s own mental health.

While it is true that being aware of one’s feelings can help protect a nurse’s mental health, this statement does not directly address the impact of these feelings on the assessment and judgment process. Emotional awareness is important for self-care and preventing burnout, but the primary rationale for emotional awareness in the context of domestic violence is to ensure that the nurse can provide objective and effective care. Therefore, this choice is not as relevant to the specific question as choice A.

Choice C Reason:

Positive feelings promote the development of sympathy for clients.

Positive feelings such as empathy and compassion are important in nursing, but they can also lead to over-identification with the client, which may result in blurred professional boundaries. While sympathy can foster a supportive relationship, it is essential for nurses to maintain a balance between empathy and professional detachment to provide objective care. This statement does not fully capture the importance of emotional awareness in preventing negative feelings from interfering with assessment and judgment.

Choice D Reason:

Strong positive feelings lead to underinvolvement with the victim.

This statement is less accurate because strong positive feelings, such as empathy and compassion, are more likely to lead to over-involvement rather than underinvolvement. Over-involvement can result in blurred boundaries and difficulty maintaining professional objectivity. However, the primary concern in the context of domestic violence is the interference of negative feelings with assessment and judgment, making this choice less relevant to the question.

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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 fifteen-year-old was referred to the adolescent mental health clinic after being arrested for prostitution. The client’s parents reported that they have run away several times and are abusive towards them. The nurse should anticipate that the diagnosis will be:

Correct Answer is C

Explanation

The rationale for the nurse needing to be aware of their own feelings while working with the family experiencing domestic violence is best explained as:

Correct Answer is A

Explanation

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