Chapter 30 Personality & Impulse Disorders Full Test Bank

Chapter 30: Personality and Impulse-Control Disorders: Nursing Care of Persons with Personality and Impulse-Control Disorders

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Analyze

Integrated Process: Nursing Process

Objective: 5

Page and Header: 537, Self-Harm Behaviors

1. Which statement indicates that a client diagnosed with borderline personality disorder (BPD) is at risk for self-injurious behavior?

A) “I have felt so down lately. I don’t enjoy doing anything anymore.”

B) “I do what I do because others tell me to do so.”

C) “When I feel extremely anxious, it is like my mind goes somewhere else.”

D) “It is almost as if as soon as I think of doing something, I immediately do it.”

Page and Header: 59, Promoting Safety

2. The sibling of a client diagnosed with borderline personality disorder asks the nurse to explain why the client engages in wrist cutting. Which response by the nurse would be most appropriate?

A) “Sometimes the self-injurious behavior is undertaken to relieve stress.”

B) “Self-injurious behavior often calms and sedates people with this diagnosis.”

C) “Sometimes they do it to avoid the onslaught of delusional thinking.”

D) “The self-mutilation often slows the mood swings your sibling experiences.”

Page and Header: 538, Biologic Theories

3. A nurse has explained some of the biologic theories of causation to a client diagnosed with borderline personality disorder. The nurse determines that the explanation has been understood when the client makes which statement?

A) “The disorder may be caused by increased serotonin activity.”

B) “The disorder is caused by decreased dopamine activity in my brain.”

C) “A frontal lobe dysfunction may be causing this condition.”

D) “A decrease in hormonal substances increases the risk for this illness.”

Page and Header: 541, Mental Health Nursing Assessment

4. Which assessment would be a priority considering the comorbid conditions associated with borderline personality disorder?

A) Nutrition patterns

B) Personal hygiene practices

C) Physical functioning

D) Somatic complaints

Page and Header: 545, Dissociation and Transient Psychotic Episodes

5. A client diagnosed with borderline personality disorder tells the nurse that, “I frequently space out.” Which response by the nurse would be most appropriate?

A) “Do you feel stressed most of the time?”

B) “Does this frighten you when it happens?”

C) “What’s happening around you when this occurs?”

D) “Do you feel as if you are out of your body?”

Page and Header: 549, Enhancing Cognitive Functioning

6. A client diagnosed with borderline personality disorder tells a nurse, “I’m afraid to get on a train because we’ll probably get into a wreck.” Which response by the nurse would be most appropriate?

A) “Have you had a bad experience riding a train?”

B) “What are the chances of that actually happening?”

C) “Now you know that won’t happen.”

D) “Have you thought about going by automobile?”

Page and Header: 533, Cluster A Disorders: Paranoid, Schizoid, and Schizotypal Personality Disorders

7. A nurse is observing a client diagnosed with borderline personality disorder on the inpatient unit. Which behavior would the nurse most likely note if the client is also paranoid?

A) Actively participating in several different groups

B) Openly verbalizing feelings

C) Participating in relationships in which the client has control

D) Adhering to the personal boundaries of others

Page and Header: 537, Impulsivity

8. A nurse assessing a client diagnosed with borderline personality disorder would most appropriately ask which question to assess the client’s level of impulsivity?

A) “What things bother you and what things make you feel happy?”

B) “Have you ever felt sorry after acting as you did on the spur of the moment?”

C) “How do you view other people around you?”

D) “Have you ever felt like you were separated from your body?”

Page and Header: 540, Recovery-Oriented Care for Persons with Borderline Personality Disorder

9. As part of a client’s treatment plan for borderline personality disorder, the client is engaged in dialectical behavior therapy. As part of the therapy, the client is learning how to control and change behavior in response to events. The nurse identifies the client as learning which type of skills?

A) Emotion regulation skills

B) Mindfulness skills

C) Distress tolerance skills

D) Self-management skills

Page and Header: 545, Cognitive Disturbances

10. Which client statement most accurately reflects the cognitive dysfunction associated with borderline personality disorder (BPD)?

A) “I was a total failure at my new job.”

B) “Sometimes things are not always clear cut.”

C) “At least some good came out of my trying.”

D) “You need to look at things in perspective.”

Page and Header: 561, Avoidant Personality Disorder

11. A nurse is reviewing the medical record of a client diagnosed with borderline personality disorder (BPD). Which risk factor would the nurse identify for this disorder?

A) Abuse as a child

B) Parental alcohol abuse

C) Poverty

D) History of depression

Page and Header: 551, Teaching Effective Ways to Communicate

12. A nurse engages in role-playing to assist the client diagnosed with borderline personality disorder in learning how to communicate effectively. Which strategy would the nurse encourage the client to use? Select all that apply.

A) “Me” statements

B) Validating perceptions with others

C) Paraphrasing before responding

D) Listening passively

E) Compromising

Page and Header: 535, Borderline Personality Disorder

13. A nurse is conducting a review class on borderline personality disorder. When describing the characteristics associated with this disorder, which would the nurse most likely include? Select all that apply.

A) Difficulty regulating moods

B) Overinflated self-identity

C) Problems with interpersonal relationships

D) Thinking that is based on delusions

E) Impulsive behavior

Page and Header: 535, Borderline Personality Disorder

14. A client diagnosed with borderline personality disorder (BPD), would be expected to demonstrate which behavior? Select all that apply.

A) Free sharing of feelings with others

B) Control necessary for a relationship

C) Fear of rejection

D) Exaggerated sense of self

E) Self-injurious behavior

Page and Header: 540, Evidence-Based Nursing Care for Persons with Borderline Personality Disorder; 541, Box 30.2

15. The assessment of a client diagnosed with borderline personality disorder reveals an unstable self-image and identity diffusion. The nurse would identify this issue based on which findings? Select all that apply.

A) Client reports of ongoing emptiness

B) Inability to remember events

C) Statements reflecting contradictory behaviors

D) Fragmented, superficial behavior

E) Reports of spacing out at different times

Page and Header: 551, Providing Family Education

16. A nurse is working with the family of a client who has been diagnosed with antisocial personality disorder. Which factor would be most important for the nurse to focus on when teaching the family about this disorder?

A) Anger management

B) Boundary setting

C) Medication therapy

D) Self-responsibility

Page and Header: 552, Antisocial Personality Disorder

17. A group of nursing students is reviewing information about antisocial personality disorder. The students demonstrate understanding of this disorder when they confirm which fact?

A) The disorder occurs more frequently in women.

B) The individual must be at least 18 years of age.

C) The disorder is found primarily in Asian individuals.

D) Alcohol abuse disorder rarely accompanies this disorder.

Page and Header: 537, Impaired Problem-Solving

18. A nurse is providing care to a client diagnosed with antisocial personality disorder. As part of the plan of care, the client is to participate in a problem-solving group. The nurse understands that this intervention is effective based on which rationale?

A) It requires the client to develop attachments.

B) It sets up specific boundaries for the client.

C) It helps to reinforce self-responsibility.

D) It avoids confrontation about dysfunctional patterns.

Page and Header: 553, Age of Onset

19. A nurse is reviewing the medical record a client diagnosed with antisocial personality disorder (ASPD). Which factor would the nurse identify as having increased the client’s risk for this condition?

A) Conduct disorder at age 12

B) History of childhood attention deficit hyperactivity disorder (ADHD)

C) Hispanic American cultural background

D) Female gender with alcohol use disorder

Page and Header: 556, Therapeutic Relationship

20. A nurse working with a client diagnosed with antisocial personality disorder needs to keep which fact in mind when focusing on a therapeutic relationship?

A) The goal is to alleviate dysfunctional thinking.

B) The relationship initially is superficial because of a lack of client commitment.

C) The client uses the relationship to change the problem behavior.

D) The client continuously focuses on new topics during the relationship.

Page and Header: 533, Schizoid Personality Disorder

21. A nurse is caring for a client diagnosed with schizoid personality trait. When developing a plan of care for the client, which would a nurse most likely include?

A) Social skills training

B) Anger management training

C) Relaxation techniques

D) Coping skills training

Page and Header: 560, Narcissistic Personality Disorder

22. A nurse suspects that the client may be displaying characteristics of narcissistic personality disorder. Which statement by the client would help support the nurse’s suspicions?

A) “I have a very important position in life; everyone I know wants to be like me.”

B) “My spouse is poisoning my food to get rid of me and marry my spouse’s boss.”

C) “I like to work alone because then I can let my thoughts wander.”

D) “I’m always the life of the party, making new friends all the time.”

Page and Header: 564, Disruptive, Impulse-Control, and Conduct Disorders

23. A nurse is developing an education plan for a client diagnosed with an impulse-control disorder. The nurse is planning to explain the emotional aspects associated with the behavior as part of the plan. Which aspect would the nurse describe as occurring first before the individual commits the act?

A) Remorse

B) Tension

C) Regret

D) Pleasure

Page and Header: 559, Histrionic Personality Disorder

24. A nurse is describing histrionic personality disorder to a group of new nurses. Which term would the nurse most likely use to?

A) Attention seeking

B) Psychopath

C) Sociopath

D) Lacking empathy

Page and Header: 533, Schizoid Personality Disorder

25. After reviewing information about different personality disorders, a group of nursing students demonstrates understanding when they identify which characteristic as associated with schizoid personality disorder?

A) Introverted

B) Overly friendly

C) Highly social

D) Exuberant

Page and Header: 552, Antisocial Personality Disorder

26. A psychiatric–mental health nurse is preparing an education plan about antisocial personality disorder for a class of community health nurses. Which term would the nurse include to describe the behaviors associated with this condition? Select all that apply.

A) Psychopath

B) Manipulator

C) Criminality

D) Sociopath

E) Psychotic

Page and Header: 554, Psychosocial Theories

27. A nurse is reading a journal article about the various theories associated with the development of antisocial personality disorder. The article mentions difficult temperament as a possible theory. The nurse demonstrates understanding of this concept when identifying which key behavior associated with a difficult temperament? Select all that apply.

A) Aggression

B) Inattention

C) Hyperactivity

D) Impulsivity

E) Depression

F) Paranoia

Page and Header: 554, Psychosocial Theories

28. A nurse is assessing a client who is reported to have a difficult temperament. Which behaviors would the nurse expect to assess? Select all that apply.

A) Aggression

B) Inattention

C) Hypoactivity

D) Impulsivity

E) Talkativeness

Page and Header: 533, Schizoid Personality Disorder

29. When developing the plan of care for a client diagnosed with schizoid personality disorder, which goal would the nurse identify? Select all that apply.

A) Enhance the experience of pleasure

B) Reduce social isolation

C) Increase emotional responsiveness to others

D) Develop a positive self-concept

E) Demonstrate mature problem-solving skills

Page and Header: 561, Avoidant Personality Disorder

30. A nurse is assessing a client diagnosed with avoidant personality disorder. Which characteristic would the nurse expect to find? Select all that apply.

A) Shyness

B) Feelings of inadequacy

C) Feelings of superiority

D) Perfectionism

E) Detail oriented

Page and Header: 563, Obsessive-Compulsive Personality Disorder

31. A nurse is conducting an in-service program on personality disorders. When describing obsessive-compulsive personality disorder, which characteristics would the nurse likely include? Select all that apply.

A) Preoccupation with control

B) Inability to delay rewards

C) Strict attention to rules

D) Difficulty with decision making

E) Relationships primarily formal and polite