Chapter 13: Personality Disorders

Chapter 13: Personality Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A physical therapist recently convicted of multiple counts of Medicare fraud says to a nurse, “Sure I overbilled. Why not? Everyone takes advantage of the government. They have so many rules; no one can follow them.” These statements show:

ANS:  D

Rationalization is being used to explain behavior and deny wrongdoing. The individual who does not believe he or she has done anything wrong will not exhibit anxiety, remorse, or guilt about the act. The patient’s remarks cannot be assessed as shameful. Lack of trust or concern that others are determined to cause harm is not evident.

DIF:    Cognitive Level: Application           REF:   Page: 215

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

2. Which intervention is appropriate for a patient with an antisocial personality disorder who frequently manipulates others?

ANS:  A

Manipulative patients frequently make requests of many different staff members, hoping someone will give in. Having only one decision-maker provides consistency and avoids the potential for playing one staff member against another. Positive reinforcement of appropriate behaviors is more effective than negative reinforcement. The behavior should not be ignored; judicious use of confrontation is necessary. Patients with antisocial personality disorders rarely have feelings of fear and inferiority.

DIF:    Cognitive Level: Application           REF:   Page: 215

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment

3. As a nurse prepares to administer a medication to a patient with a borderline personality disorder, the patient says, “Just leave it on the table. I’ll take it when I finish combing my hair.” What is the nurse’s best response?

ANS:  C

The individual with a borderline personality disorder characteristically demonstrates manipulative, splitting, and self-destructive behaviors. Consistent limit setting is vital for the patient’s safety, as well as to prevent splitting other staff members. “Why” questions are not therapeutic.

DIF:    Cognitive Level: Application           REF:   Pages: 215-217|Page: 223

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment

4. What is an appropriate initial outcome for a patient with a personality disorder who frequently manipulates others? The patient will:

ANS:  C

Acknowledging manipulative behavior is an early outcome that paves the way for taking greater responsibility for controlling manipulative behavior at a later time. Identifying anger relates to anger and aggression control. Using manipulation to get legitimate needs is an inappropriate outcome. The patient will ideally use assertive behavior to promote the fulfillment of legitimate needs. Accepting fulfillment of requests within an hour rather than immediately relates to impulsivity and immediacy control.

DIF:    Cognitive Level: Analysis                REF:   Pages: 215-217|Pages: 221-222

TOP:   Nursing Process: Outcomes Identification

MSC:  NCLEX: Psychosocial Integrity

5. Consider these comments to three different nurses by a patient with an antisocial personality disorder: “You’re a better nurse than the day shift nurse said you were”; “Another nurse said you don’t do your job right”; “You think you’re perfect, but I’ve seen you make three mistakes.” Collectively, these interactions can be assessed as:

ANS:  C

Patients manipulate and control staff members in various ways. By keeping staff members off balance or fighting among themselves, the person with an antisocial personality disorder is left to operate as he or she pleases. Seductive behavior has sexual connotations. The patient is displaying the opposite of detached behavior. Guilt is not evidenced in the comments.

DIF:    Cognitive Level: Application           REF:   Pages: 215-217|Pages: 222-223

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity