1. The nursing diagnosis that would be most appropriate for a 22-year old client who uses ritualistic behavior would be:
a. Ineffective coping
b. Impaired adjustment
c. personal identity disturbance
d. Sensory/perceptual alterations
2. 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:
a. Fluvoxamine (Luvox)
b. Benztropine (Cogentin)
c. Amantadine (Symmetrel)
d. Diphenhydramine (Benadryl)
3. A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with the parents, which information would the nurse expect to be included in the client’s history? Select all that apply.
b. Lability of mood
c. Ritualistic behavior
d. psychomotor retardation
e. self-destructive behavior
4. 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:
a. Control anger
b. reduce anxiety
c. Set realistic goals
d. Become more self-aware
5. When working with the nurse during the orientation phase of the relationship, a client with a borderline personality disorder would probably have the most difficulty in:
a. Controlling anxiety
b. terminating the session on time
c. Accepting the psychiatric diagnosis
d. Setting mutual goals for the relationship
6. A client with a diagnosis of borderline personality disorder has negative feelings toward the other clients on the unit and considers them all to be “bad.” The nurse understands this defense is known as:
c. Passive aggression
d. Reaction formation
7. The client with antisocial personality disorder:
a. Suffers from a great deal of anxiety
b. Is generally unable to postpone gratification
c. Rapidly learns by experience and punishment
d. Has a great sense of responsibility toward others
8. A person with antisocial personality disorder has difficulty relating to others because of never having learned to:
a. Count on others
b. Empathize with others
c. Be dependent on others
d. Communicate with others socially
9. A young, handsome man with a diagnosis of antisocial personality disorder is being discharged from the hospital next week. He asks the nurse for her phone number so that he can call her for a date. The nurse’s best response would be:
a. “We are not permitted to date clients.”
b. “No, you are a client and I am a nurse.”
c. “I like you, but our relationship is professional.”
d. “It’s against my professional ethics to date clients.”
10. When caring for a client with a diagnosis of schizotypal personality disorder, the nurse should:
a. Set limits on manipulative behavior
b. encourage participation in group therapy
c. Respect the client’s needs for social isolation
d. Understand that seductive behavior is expected.
11. A nurse is orienting a new client to the unit when another client rushes down the hallway and asks the nurse to sit down and talk. The client requesting the nurse’s attention is extremely manipulative and uses socially acting-out behaviors when demands are unmet. The nurse should:
a. Suggest that the client requesting attention speak with another staff member
b. Leave the new client and talk with the other client to avoid precipitating acting out behavior
c. Tell the interrupting client to sit down and be patient, stating, “I’ll be back as soon as possible.”
d. Introduce the two clients and suggest that the client join the new client and the nurse on the tour
12. A client with a diagnosis of narcissistic personality disorder has been given a day pass from the psychiatric hospital. The client is due to return at 6pm. At 5pm the client telephones the nurse in charge of the unit and says “6 o’clock is too early. I feel like coming back at 7:30.” The nurse would be most therapeutic by telling the client to:
a. Return immediately, to demonstrate control
b. Return on time or restrictions will be imposed
c. come back at 6:45, as a compromise to set limits
d. Come back as soon as possible or the police will be sent
13. An adult client with a borderline personality disorder become nauseated and vomits immediately after drinking after drinking 2 ounces of shampoo as a suicide gesture. The most appropriate initial response by the nurse would be to:
a. Promptly notify the attending physician
b. Immediately initiate suicide precautions
c. Sit quietly with the client until nausea and vomiting subsides
d. Assess the client’s vital signs and administer syrup of ipecac
14. A nurse notices that a client is mistrustful and shows hostile behavior. Which of the following types of personality disorder is associated with these characteristics?
15. Which of the following statements is typical for a client diagnosed with a personality disorder?
a. “I understand you’re the one to blame.”
b. “I must be seen first; it’s not negotiable.”
c. “I see nothing humorous in this situation.”
d. “I wish someone would select the outfit for me.”
16. Which of the following characteristics is expected for a client with paranoid personality disorder who receives bad news?
a. The client is overly dramatic after hearing the facts
b. The client focuses on self to not become over-anxious
c. The client responds from a rational, objective point of view
d. The client doesn’t spend time thinking about the information.
17. Which of the following types of behavior is expected from a client diagnosed with a paranoid personality disorder?
18. Which of the following interventions is important for a client with paranoid personality disorder taking olanzapine (Zyprexa)?
a. Explain effects of serotonin syndrome
b. Teach the client to watch for extrapyramidal adverse reactions
c. Explain that the drug is less effective if the client smokes
d. Discuss the need to report paradoxical effects such as euphoria.
19. A client with antisocial personality is trying to convince a nurse that he deserves special privileges and that an exception to the rules should be made for him. Which of the following responses is the most appropriate?
a. “I believe we need to sit down and talk about this.”
b. “Don’t you know better than to try to bend the rules?”
c. “What you’re asking me to do is unacceptable.”
d. “Why don’t you bring this request to the community meeting?”
20. A nurse notices other clients on the unit avoiding a client diagnosed with antisocial personality disorder. When discussing appropriate behavior in group therapy, which of the following comments is expected about this client by his peers?
a. Lack of honesty
b. Belief in superstitions
c. Show of temper tantrums
d. Constant need for attention