AAH Ch22 Personality Worksheet PDF

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Chapter 22: Personality Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____

1. The client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions during the assessment interview. Which response would the nurse make? 1. “You are very disrespectful. You need to learn to control yourself.” 2. “I understand that you are angry, but this behavior will not be tolerated.” 3. “What behaviors could you modify to improve this situation?” 4. “Which antipersonality disorder medications have helped you in the past?”

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2. At 11:30 p.m. the client diagnosed with antisocial personality disorder demands to phone a lawyer to file for a divorce. Unit rules state that no phone calls are permitted after 10 p.m. Which nursing response is most appropriate? 1. “Go ahead and use the phone. I know this pending divorce is stressful.” 2. “You know better than to break the rules. I’m surprised at you.” 3. “It is after the 10 p.m. phone curfew. You will be able to call tomorrow.” 4. “A divorce shouldn’t be considered until you have had a good night’s sleep.”

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3. The client diagnosed with paranoid personality disorder becomes aggressive on the unit. Which nursing intervention is most appropriate? 1. Provide objective evidence that reasons for violence are unwarranted. 2. Initially restrain the client to maintain safety. 3. Use clear, calm statements with a confident physical stance. 4. Empathize with the client’s paranoid perceptions.

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4. The client diagnosed with borderline personality disorder brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. How can the nursing staff best handle this situation? 1. Allow the clients to apply the autocratic process when developing unit rules. 2. Maintain consistency of care and open communication to avoid staff manipulation. 3. Allow the client spokesman to verbalize concerns during a unit staff meeting. 4. Maintain unit order by the application of punitive leadership.

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5. Which approach should the nurse use to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder (BPD)? 1. Being firm, consistent, and empathic while addressing specific client behaviors 2. Promoting client self-expression by implementing laissez-faire leadership 3. Using authoritative leadership to help clients learn to conform to society norms 4. Overlooking inappropriate behaviors to avoid providing secondary gains

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6. Which physically healthy adult client should a nurse identify as exhibiting the characteristics of a dependent personality disorder? 1. Meets social needs by contact with 15 cats 2. Has a history of depending on intense relationships to meet basic needs 3. Lives with parents and relies totally on public transportation 4. Is serious, inflexible, and lacks spontaneity Copyright © 2020 F. A. Davis Company

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7. The client expresses low self-worth, has much difficulty making decisions, avoids positions of responsibility, and has a behavioral pattern of “suffering” in silence. Which information best explains the childhood nurturance of this client’s personality disorder? 1. Was provided from many sources, and independent behaviors were encouraged 2. Was provided exclusively from one source, and independent behaviors were discouraged 3. Was provided exclusively from one source, and independent behaviors were encouraged 4. Was provided from many sources, and independent behaviors were discouraged

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8. Family members of a client ask the nurse to explain the difference between schizoid and avoidant personality disorders. Which nursing response is appropriate? 1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed with schizoid personality disorder prefer to be alone. 2. Clients diagnosed with schizoid personality disorder exhibit delusions and hallucinations, while clients diagnosed with avoidant personality disorder do not. 3. Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with schizoid personality disorder are dull and vacant. 4. Clients diagnosed with schizoid personality disorder have a history of psychosis, while clients diagnosed with avoidant personality disorder remain based in reality.

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9. Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder? 1. Altered thought processes R/T increased stress 2. Risk for suicide R/T loneliness 3. Risk for violence: directed toward others R/T paranoid thinking 4. Social isolation R/T inability to relate to others

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10. Looking at a slightly bleeding paper cut, the client screams, “Somebody help me quick! I’m bleeding. Call 911!” The nurse should identify this behavior as characteristic of which personality disorder? 1. Schizoid 2. Obsessive-compulsive 3. Histrionic 4. Paranoid

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11. When planning care for a client diagnosed with borderline personality disorder, which self-harm behavior should a nurse expect the client to exhibit? 1. Highly lethal methods to commit suicide 2. Suicidal gestures to elicit a rescue response from others 3. Isolation and starvation as suicidal methods 4. Self-mutilation from decreased endorphins in the body

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12. The nurse tells a client diagnosed with obsessive-compulsive personality disorder that the nursing staff will start alternating weekend shifts. Which response should the nurse expect from this client? 1. “You really don’t have to go by that schedule. I’d just stay home sick.” 2. “There has got to be a hidden agenda behind this schedule change.”

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3. “Who do you think you are? I expect to interact with the same nurse every Saturday.” 4. “You can’t make these kinds of changes! Isn’t there a rule that governs this decision?” ____

13. Which reaction to a compliment from a staff member should the nurse identify as a typical response from a client diagnosed with avoidant personality disorder? 1. Interpreting the compliment as a secret code used to increase personal power 2. Feeling the compliment was well deserved 3. Being grateful for the compliment but fearing later rejection and humiliation 4. Wondering what deep meaning and purpose is attached to the compliment

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14. Which factor differentiates a client diagnosed with schizotypal personality disorder from a client diagnosed with schizoid personality disorder? 1. Clients diagnosed with schizotypal personality disorder are treated with cognitive behavioral therapy, whereas clients diagnosed with schizoid personality disorder need medications. 2. Clients diagnosed with schizoid personality disorder experience anxiety only in social settings, whereas clients diagnosed with schizotypal personality disorder experience generalized anxiety. 3. Clients diagnosed with schizotypal personality disorder experience social anxiety from paranoid fears, whereas clients diagnosed with schizoid personality disorder would isolate themselves on a continual basis. 4. Clients diagnosed with schizoid personality disorder have magical thinking and depersonalization, whereas clients diagnosed with schizotypal personality disorder do not.

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15. Which symptom should the nurse observe in a client diagnosed with obsessive-compulsive personality disorder? 1. Intrusive and persistent thoughts 2. Unwanted, repetitive ritualistic behavior 3. Lack of spontaneity when dealing with others 4. Feelings of “sixth sense” that are externally imposed

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16. Which client is most likely to be admitted to an inpatient facility for self-destructive behaviors? 1. One with antisocial personality disorder 2. One with borderline personality disorder 3. One with schizoid personality disorder 4. One with paranoid personality disorder

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17. When planning care for clients diagnosed with personality disorders, which treatment goal is appropriate? 1. To stabilize the client’s pathology by using the correct combination of psychotropic medications 2. To change the characteristics of the dysfunctional personality 3. To reduce personality trait inflexibility that interferes with functioning and relationships 4. To decrease the prevalence of neurotransmitters at receptor sites

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18. Which client response would reflect the impulsive self-destructive behavior that is commonly associated with borderline personality disorder when the day-shift nurse leaves the unit? 1. The client suddenly leans on the nurse’s arm and whispers, “The night nurse is evil. You have to stay.” 2. The client suddenly hugs the nurse’s arm and states, “I will be up all night if you don’t stay with me.” 3. The client suddenly grabs the nurse’s arm, yelling, “Please don’t go! I can’t sleep without you being here.” 4. The client suddenly shows the nurse a bloody arm and states, “I cut myself because you are leaving me.”

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19. Which nursing diagnosis is the priority when providing nursing care to a client diagnosed with paranoid personality disorder? 1. Risk for violence: directed toward others R/T suspicious thinking 2. Risk for suicide R/T altered thought 3. Altered sensory perception R/T increased levels of anxiety 4. Social isolation R/T inability to relate to others

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20. Which nursing intervention is appropriate when caring for a client diagnosed with borderline personality disorder? 1. Seclude the client when inappropriate behaviors are exhibited. 2. Rotate staff members who work with the client. 3. Teach about antianxiety medications to improve medication compliance. 4. Offer sympathy when client engages in self-mutilation.

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21. The client presents at an outpatient clinic appointment and states, “My dead husband returned to me during a séance.” Which personality disorder should the nurse associate with this behavior? 1. Obsessive-compulsive 2. Schizotypal 3. Narcissistic 4. Borderline

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22. The nurse is teaching staff about clients diagnosed with histrionic personality disorder and the quality of their relationships. Which statement made by a staff member indicates learning has occurred? 1. “Their dramatic style tends to make their interpersonal relationships interesting and fulfilling.” 2. “Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs.” 3. “They tend to develop few relationships because they are strongly independent but generally maintain deep affection.” 4. “They pay particular attention to details, which can interfere with the development of relationships.”

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23. During an interview, which client statement should alert the nurse to a potential diagnosis of schizotypal personality disorder? 1. “I don’t have a problem. My family is inflexible, and my relatives are out to get me.” Copyright © 2020 F. A. Davis Company

2. “I am so excited about working with you. Have you noticed my new nail polish, ‘Ruby Red Roses’?” 3. “I spend all my time tending my bees. I know a whole lot of information about bees.” 4. “I am getting a message from the beyond that we have been involved with each other in a previous life.” ____

24. Which nursing diagnosis is priority when providing nursing care to a client diagnosed with avoidant personality disorder? 1. Risk for violence: directed toward others R/T suspicious thinking 2. Risk for suicide R/T altered thought 3. Altered sensory perception R/T increased levels of anxiety 4. Social isolation R/T fear of rejection

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____

25. The nurse is admitting a client with a diagnosis of schizotypal personality disorder. Which client findings would make the nurse question this diagnosis? (Select all that apply.) 1. Is the center of attention 2. Has unusual perceptual experiences 3. Has a bipolar disorder 4. Is odd and eccentric but not delusional 5. Has autism spectrum disorder

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26. Which statements represent positive outcomes for clients diagnosed with narcissistic personality disorder? (Select all that apply.) 1. The client will relate one empathetic statement to another client in group by day four. 2. The client will identify one personal limitation by day two. 3. The client will acknowledge one strength that another client possesses by day three. 4. The client will list four personal strengths by day three. 5. The client will discuss two lifetime achievements by discharge.

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27. The nurse is caring for a client diagnosed with antisocial personality disorder. Which factors should the nurse consider when planning this client’s care? (Select all that apply.) 1. This client has personality traits that are deeply ingrained and difficult to modify. 2. This client needs medication to treat the underlying physiological pathology. 3. This client uses manipulation, making the implementation of treatment problematic. 4. This client wants instant gratification, which hinders compliance with a plan of care. 5. This client is likely to have secondary diagnoses of substance abuse and depression.

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28. The nurse is assessing a client for antisocial personality disorder. According to the DSM-5, which symptoms must the client meet in order to be assigned this diagnosis? (Select all that apply.) 1. Age of at least 18 years old 2. Deceitful for personal gain 3. Frequent feelings of being down, remorseful, or hopeless 4. Disregard for and failure to honor financial obligations 5. Avoidance of social events and interaction with others

Completion Complete each statement. 29. ____________________ personality disorder is characterized by a profound defect in the ability to form personal relationships or to respond to others in any meaningful emotional way. 30. ____________________ personality disorder is characterized by colorful, dramatic, and extroverted behavior in excitable, emotional people. 31. ____________________ personality disorder is characterized by a lack of self-confidence and excessive need to be taken care of that leads to a passive and submissive role. 32. ____________________ personality disorder is a pervasive mistrust and suspiciousness of others, such that their motives are interpreted as malevolent.

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