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Administering tranquilizing drugs is not the first-line action unless the client displays acute agitation or psychosis. Medications may help control mood instability but do not prevent self-injury or suicidal behavior, which is the immediate concern.

Encouraging the client to verbalize hostile feelings is therapeutic but not the priority intervention during the acute phase after self-harm. Emotional expression can be explored after the client is physically safe and stabilized.

Exploring alternative ways of handling frustration is a rehabilitative approach used in later stages of therapy. Initially, the focus must be on observation and safety to prevent recurrence of self-inflicted injuries.

Asking directly about suicidal thoughts is appropriate when assessing safety, but it does not address issues of identity or dependency. While suicide risk must always be monitored, this intervention is unrelated to the specific nursing diagnosis of disturbed personal identity.

Maintaining a low level of stimuli is a strategy for anxiety or agitation, not identity disturbance. This action may help calm the client temporarily but does not promote self-awareness or personal growth.

Frequent orientation to reality is indicated for psychosis or confusion, not borderline personality disorder. Clients with BPD are typically reality-oriented but struggle with emotional instability and self-perception, making this intervention irrelevant.

Offering to remain with the client during initial interactions is useful for those with anxiety or social withdrawal, not for antisocial personality disorder. These clients often display excessive confidence and do not require supportive presence for social engagement.

Recognizing “splitting” staff is crucial in borderline personality disorder, not antisocial. ASPD clients manipulate others for personal gain but do not typically engage in splitting behavior characterized by idealization and devaluation of staff members.

Allowing the client to take responsibility for self-care is appropriate for promoting independence, but in this case, it does not address the self-esteem disturbance or the psychological mechanisms sustaining the client’s grandiosity. The focus should be on self-reflection and emotional understanding first.

Peculiarities of ideation are typical of schizotypal personality disorder, which involves eccentric thinking, magical beliefs, and perceptual distortions, not the grandiosity or admiration-seeking seen in narcissism.

Constant need for approval is more consistent with dependent personality disorder, where clients rely excessively on others for reassurance and decision-making, unlike narcissistic individuals who seek admiration rather than approval.

Impulsivity and self-destructive tendencies are associated with borderline personality disorder, characterized by emotional instability and fear of abandonment, not with narcissistic traits of superiority and control.

Ambivalence refers to simultaneous opposing emotions toward the same person or situation. It reflects emotional conflict but not the rigid separation of good and bad qualities characteristic of splitting.

Passive aggression involves indirect expression of hostility, such as procrastination or resistance, rather than overtly labeling others as bad. It is a behavioral response, not a cognitive distortion like splitting.

Reaction formation occurs when an individual behaves in a way opposite to their true feelings, such as expressing affection toward someone they actually dislike. This differs from splitting, where individuals categorize people into extremes without emotional reversal.

Exploring job possibilities is premature, as vocational planning requires emotional stability and consistent functioning. Early treatment should focus on safety, boundaries, and basic emotional regulation before addressing long-term goals.

Discussing victimization may evoke overwhelming emotions and intensify instability early in therapy. This should occur later, once a trusting and structured therapeutic relationship is established and the client has learned basic coping skills.

Spending excessive time with the nurse fosters dependency and reinforces boundary issues, which are central to BPD. Frequent, brief, and predictable contacts are more therapeutic and prevent overattachment or manipulation.

Stating that the nurse is part of a team that shares important information reinforces open communication and teamwork. It sets clear limits and prevents the client from using secrecy to divide staff, thus avoiding splitting.

Refusing to promise confidentiality upholds honesty and professional boundaries. It ensures transparency and maintains consistency among caregivers, protecting against manipulation and staff conflict.

Explaining that information will be handled in the client’s best interests and shared appropriately with the team promotes trust while maintaining ethical standards. It prevents the client from perceiving any one staff member as exclusively loyal or protective.

Physically restraining the client without cause is inappropriate unless there is immediate danger. This action could provoke anger, increase resistance, and damage trust, escalating the situation unnecessarily.

Using a loud or authoritative tone draws attention to the client, reinforcing their need for admiration and control. It can also embarrass or provoke the client, leading to defiance or aggression.

Telling the client the player will not give autographs introduces unnecessary information and may lead to argument or denial. It also fails to address the behavioral issue—following group expectations and respecting boundaries.

Teaching and role-modeling assertiveness are appropriate for clients who lack confidence or have difficulty expressing needs, such as those with dependent or avoidant disorders, not for manipulative antisocial clients.

Using a gentle and reassuring approach can be misinterpreted as weakness, encouraging manipulation or exploitation. Clients with ASPD often test limits and may take advantage of overly permissive staff.

A democratic and overly empathetic style is not effective with antisocial clients. These individuals require firm, direct communication and consistent enforcement of rules rather than negotiation or shared decision-making, which they may manipulate.