totality of emotions and behavioral characteristics that are particular to a specific person and that remains somewhat stable and predictable over time Show characteristics that a person is born with or develops early in life. stable over time 3 when do personality disorders occur? when traits become inflexible and rigid 4 paranoid personality disorder mistrust of others suspicious and always on guard oversensitive and insensitive to others inability to form personal relationships fails to respond to others in a meaningful way "emotionally cold" too serious lacked a nurturing childhood 6 1.When assessing a client diagnosed with narcissistic personality disorder, the nurse grandiose feelings of self importance graver than schizoid "magical" thinking illusions under stress they may experience psychotic symptoms socially irresponsible disregards the rights of others fails to conform to the law 9 borderline personality disorder fluctuating extreme attitudes highly impulsive emotionally unstable lacks clear sense of identity "splitting" personality excitable, emotional, colorful, dramatic, extroverted attention seekers/seductive/manipulative more common in women. 2-3% of the population exaggerated sense of self worth lack of empathy self centered more common in men than women extremely sensitive to rejection/ socially withdrawn awkward and uncomfortable in social situations lonely and feels unwanted 13 2.A client diagnosed with a personality disorder is cold, aloof, and avoids others on the unit. The nurse recognizes that this behavior is symptomatic of which personality disorder? A.Schizoid personality disorder B.Dependent personality disorder C.Borderline personality disorder D.Antisocial personality disorder relies on others for emotional support more common in women and more common in the youngest child lack of self confidence: evidenced in voice, posture, and mannerisms 15 obsessive compulsive disorder inflexibility in the way things are done. more common in men and the oldest child in a family on the surface: calm and controlled. underneath: conflict socially polite 16 why is it called "borderline" personality? between neuroses and psychosis 17 characteristics of borderline personality disorder ▪Chronic depression ▪Inability to be alone ▪Clinging and distancing behaviors ▪Splitting ▪Manipulation ▪Self-destructive behaviors ▪Impulsivity 18 predisposing factors of personality disorder ▪Biochemical:Possible serotonergic defect ▪Genetic:Possible familial connection with depression ▪Psychosocial influences ▪Childhood trauma and abuse ▪Developmental factors Fixed in the rapprochement phase of development (16 to 24 months old). The child fails to achieve task of autonomy 19 A client diagnosed with borderline personality disorder is admitted to a psychiatric unit. Which behavior pattern would the nurse expect to observe? A.Social isolation B.Suspiciousness of others C.Bizarre speech patterns D.Generates conflict among the staff
d-they have "splitting" behaviors which causes conflict 20 In assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to observe? A.Predictability B.Controlled anger C.Little tolerance for being alone D.Stable and satisfactory relationships they do not like to be alone 21 borderline personality disorder diagnosis Risk for Suicide risk for self mutilation complicated greiving impaired social interaction Disturbed personal identity related to underdeveloped ego Anxiety (severe to panic) related to unconscious conflicts based on fear of abandonment ¡Chronic low self-esteem related to lack of positive feedback 22 nursing implementation for a patient with Borderline personality safety first confront internalized anger to help develop the personality 23 why is antisocial disorder not seen in clinical settings? 24 predisposing factors of antisocial personality disorder
25 An individual, with a history of antisocial personality disorder, was arrested for driving A.“It's not my fault.” B.“I'm too ashamed to talk about it.” C.“I just don't remember doing it.” D.“I'm really sorry about all the people I've hurt.” 26 interventions for antisocial personality disorder
27 how to treat personality disorder ¡Interpersonal Psychotherapy ¡Psychoanalytical Psychotherapy ¡Milieu or Group Therapy ¡Cognitive/Behavioral Therapy ¡Dialectical Behavior Therapy ¡Psychopharmacology 28 ritualistic behaviors- diagnosis 29 A psychiatrist prescribes an anti-obsessional agent for a client who is using ritualistic behavior. A common anti-anxiety medication used for this type of client would be: 30 A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit’s rules. This behavior should be confronted because it will help the client: make the patient aware of the problem 31 The client with antisocial personality disorder: 32 A person with antisocial personality disorder has difficulty relating to others because of never having learned to 33 antisocial client asks for the nurse's phone number. What do you do? say, "i like you but our relationship is professional". 34 During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the most
appropriate nursing statement to address this behavior? 35 A client diagnosed with antisocial personality disorder comes to a nurses' station at 11:00 p.m. requesting to
phone a lawyer to discuss filing for a divorce. The unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing reply is most appropriate? 36 A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate? 37 A highly emotional client presents at an outpatient clinic appointment wearing
flamboyant attire, spiked heels, and theatrical makeup. Which personality disorder should a nurse associate with this assessment data? 38 A client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of
unit rules. How can the nursing staff best handle this situation? 39 Which nursing approach should be used to maintain a therapeutic relationship with a
client diagnosed with borderline personality disorder? 40 Which adult client should a nurse identify as exhibiting the characteristics of a
dependent personality disorder? 41 A pessimistic client
expresses low self-worth, has much difficulty making decisions, avoids positions of responsibility, and has a behavioral pattern of "suffering" in silence. Which underlying cause of this client's personality disorder should a nurse recognize? 42 Family members of a client ask a nurse to explain the difference between schizoid and avoidant personality disorders. Which is the appropriate nursing reply? 43 During an interview, which client statement indicates to a nurse that a potential diagnosis of schizotypal personality disorder should be considered? 44 A nursing instructor is teaching students about clients diagnosed with histrionic personality disorder and the quality of their relationships. Which student statement indicates that learning has occurred? 45 Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder? 46 When planning care for a client diagnosed with borderline personality disorder, which self-harm behavior should a nurse expect the client to exhibit? 47 Which client situation should a nurse identify as reflective of the impulsive behavior that is commonly associated with borderline personality disorder? ANS: D 48 Which nursing diagnosis should be prioritized when providing care to a client diagnosed with paranoid personality disorder? 49 From a behavioral perspective, which nursing intervention is most appropriate when caring for a client diagnosed with borderline personality disorder? 50 A nurse tells a client that the nursing staff will start alternating weekend shifts. Which response should a nurse identify as characteristic of clients diagnosed with obsessive-compulsive personality disorder? 51 Looking at a slightly bleeding paper cut, the client screams, "Somebody help me, quick! I'm bleeding. Call 911!" A nurse should identify this behavior as characteristic of which personality disorder? 52 Which reaction to a compliment from another client should a nurse identify as a typical response from a client diagnosed with avoidant personality disorder? 53 Which client symptoms should lead a nurse to suspect a diagnosis of obsessive-compulsive personality disorder? 54 Which client is a nurse most likely to admit to an inpatient facility for self-destructive behaviors? 55 When planning care for clients diagnosed with personality
disorders, what should be the anticipated treatment outcome? 56 The nurse plans to confront a client about secondary gains related to extreme dependency on
spouse. Which nursing statement would be most appropriate? 57 The nurse should recognize which factors that distinguish personality disorders from psychosis? A. Functioning is more limited in personality disorders than in psychosis. 58 Which client statement would demonstrate a common characteristic of Cluster "B" personality disorder? 59 When a client on an acute care psychiatric unit demonstrates behaviors and verbalizations indicating a lack of guilt feelings, which nursing intervention would help the client to meet desired outcomes? ANS: A 60 Which characteristics should a nurse recognize as being exhibited by individuals
diagnosed with any personality disorders? 61 A nurse would expect a client diagnosed with schizotypal personality disorder to exhibit which characteristic? c- "magical thinking" and possibly psychosis under stress 62 While improving, a client demands to have a phone installed in the intensive care unit (ICU) room. When a nurse states, "This is not
allowed. It is a unit rule." The client angrily demands to see the doctor. Which approach should the nurse use in this situation? 63 Which nursing statement reflects a common characteristic of a client diagnosed with paranoid
personality disorder? 64 A client exhibits dependency on staff and peers and expresses fear of abandonment. Using Mahler's theory of object relations, which
should the nurse expect to note in this client's childhood? 65 A client diagnosed with cluster "C" traits sits alone and ignores other's attempts to converse. When ask to join a group the client states, "No thanks." In this
situation, which should the nurse assign as an initial nursing diagnosis? 66 Which statements represent positive outcomes for clients diagnosed with narcissistic personality disorder? (Select all that apply.) 67 A nurse is caring for a group of clients within the DSM-IV-TR cluster B category of personality disorders. Which factors should the nurse consider when planning client care? (Select all that apply.) How are personality disorders assessed?Personality disorder can be assessed in a number of ways, including self-report, checklists and structured clinical interview. Numerous instruments are available to aid the clinician in making a diagnosis. These differ in terms of both reliability and validity.
Which is a primary behavior of a client diagnosed with antisocial personality disorder?People with antisocial personality disorder tend to antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior.
Which of the following underlying emotions is commonly seen in avoidant personality disorder?Avoidant personality disorder is grouped with other personality disorders marked by feelings of nervousness and fear. People with avoidant personality disorder have chronic feelings of inadequacy and are highly sensitive to being negatively judged by others.
What are the most commonly seen personality disorders in clinical settings?According to a major study, the most prevalent personality disorder is obsessive-compulsive personality disorder. The second most common is narcissistic personality disorder, followed by borderline personality disorder.
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