Chapter 24: Personality Disorders

Chapter 24: Personality Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A health care provider recently convicted of Medicare fraud says to a nurse, “Sure I overbilled. Everyone takes advantage of the government. There are too many rules to follow and I should get the money.” 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 manifest anxiety, remorse, or guilt about the act. The patient’s remarks cannot be assessed as shameful. Lack of trust and concern that others are determined to do harm is not shown.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 469 (Table 24 – 4)                   TOP:   Nursing Process: Assessment

MSC:  Client Needs: Psychosocial Integrity

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

ANS:  A

Manipulative people frequently make requests of many different staff, hoping one will give in. Having 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.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 463 (Table 24–2) | Page 465 | Page 469 (Table 24–4)

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Safe, Effective Care Environment

3. As a nurse prepares to administer medication to a patient diagnosed 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, but also to prevent splitting other staff. “Why” questions are not therapeutic.   See relationship to audience response question.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 463 (Table 24 – 2) | Page 466-467 | Page 469 (Table 24 – 4)

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Safe, Effective Care Environment

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

ANS:  C

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

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 463 (Table 24–5) | Page 466-467 | Page 469 (Table 24–4)

TOP:   Nursing Process: Outcomes Identification

MSC:   Client Needs: Psychosocial Integrity