(Answer and Rationale) Personality Disorders NCLEX Review

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1. ANSWER A. Ineffective coping is the impairment of a person’s adaptive behaviors and problem-solving abilities in meeting life’s demands; ritualistic behavior fits under this category as a defining characteristic.

2. ANSWER A. This drug blocks the uptake of serotonin.

3. ANSWER A, B, E.

4. ANSWER D. Client’s must first become aware of their behavior before they can change it. (3) Occurs after the client is aware of the behavior and has a desire to change the behavior.

5. ANSWER D. Clients with borderline personality disorders frequently demonstrate a pattern of unstable interpersonal relationships, impulsiveness, affective instability, and frantic efforts to avoid abandonment; these behaviors usually create great difficulty in establishing mutual goals.

6. ANSWER A. Splitting is the compartmentalization of opposite-affect states and failure to integrate the positive and negative aspects of self or others.

7. ANSWER B. Individuals with this disorder tend to be self-centered and impulsive. They lack judgment and self-control and do not profit from their mistakes.

8. ANSWER B. The lack of superego control allows the ego and the id to control the behavior. Self-motivation and self-satisfaction are of paramount concern.

9. ANSWER C. This accepts the client as a person of worth rather than being cold or implying rejection. However, the nurse maintains a professional rather than a social role.

10. ANSWER C. These clients are withdrawn, aloof, and socially distant; allowing distance and providing support may encourage the eventual development of a therapeutic alliance. Group therapy would increase this client’s anxiety; cognitive or behavioral therapy would be more appropriate.

11. ANSWER C. This sets realistic limits on behavior without rejecting the client

12. ANSWER B. This sets limits, points out reality, and places responsibility for behavior on the client.

13. ANSWER C. This intervention demonstrates the nurse’s caring presence which is vital for this client. (1) Although the treatment team does need to know about the event, notification is not the immediate concern. (2) This is premature and it reinforces the client’s predisposition to manipulative behavior. (4) This medication is inappropriate in this situation; vomiting would be expected after the ingestion of shampoo.

14. ANSWER D. Paranoid individuals have a need to constantly scan the environment for signs of betrayal, deception, and ridicule, appearing mistrustful and hostile. They expect to be tricked or deceived by others.

15. ANSWER C. Clients with paranoid personality disorder tend to be extremely serious and lack a sense of humor.

16. ANSWER C. Clients with paranoid personality disorder are affectively restricted, appear unemotional, and appear rational and objective.

17. ANSWER C. People with paranoid personality disorders are hypersensitive to perceived threats. Schizotypal personalities appear eccentric and engage in activities others find perplexing. Clients with narcissistic personality disorder are interpersonally exploitative to enhance themselves or indulge in their own desires. A client with histrionic personality disorder can be extremely seductive when in search of stimulation and approval.

18. ANSWER C. Olanzapine (Zyprexa) is less effective for clients who smoke cigarettes. Olanzapine doesn’t cause euphoria (damn), and extrapyramidal side effects aren’t a problem. However, the client should be aware of adverse effects such as tardive dyskinesia.

19 ANSWER C. These clients often try to manipulate the nurse to get special privileges or make exceptions to the rules on their behalf. By informing the client directly when actions are inappropriate, the nurse helps the client learn to control unacceptable behaviors by setting limits. By sitting down to talk about the request, the nurse is telling the client there’s room for negotiating when there is none.

20. ANSWER A. Clients with antisocial personality disorder tend to engage in acts of dishonesty, shown by lying.