Nclex-Rn Practice Questions-Care Of The Psychiatric Client - Personality Disorders Part 2
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Question 1 |
A nurse tells a client with a personality disorder that he must clean his room before he can go to the dayroom. The client asks if he can play one game of pool first. What is the most appropriate response by the nurse?
A | “You can play one quick game. Then you have to clean your room.” |
B | “No, you may not.” |
C | “No, you may not play pool first. The rules were explained to you.” |
D | “Yes, you may play a quick game. But don’t tell the other clients about this.” |
Question 2 |
A nurse is evaluating the effectiveness of an assertiveness group that a client with dependent personality disorder attended. Which client statement indicates the group had therapeutic value?
A | “I can’t seem to do the things other people do.” |
B | “I wish I could be more organized like other people.” |
C | “I want to talk about something that’s bothering me.” |
D | “I just don’t want people in my family to fight anymore.” |
Question 3 |
The nurse is expecting the psychiatrist to order an antidepressant for a client with borderline personality disorder. Which of the following would be best for this client?
A | Monoamine oxidase inhibitors (MAOIs) work best for those with a borderline personality disorder because the effects are felt very quickly. |
B | Selective serotonin reuptake inhibitors (SSRIs) in addition to an atypical antipsychotic treat dysphoria, mood instability, and impulsivity in clients with borderline personality disorder. |
C | Antipsychotics treat illusions, ideas of reference, paranoid thinking, anxiety, and hostility in clients. |
D | Anxiolytics will reduce the anxiety seen in borderline personality disorder clients. |
Question 4 |
A nurse notices that a client with dependent personality disorder is depressed. Which factor is assessed as contributing to depression?
A | Unmet needs |
B | Sense of smothering |
C | Messy, unkempt appearance |
D | Difficulty delaying gratification |
Question 5 |
A client with dependent personality disorder makes the following statement: “I’ll never be able to take care of myself.” Which response by the nurse is best?
A | “How can you say that? You can function.” |
B | “Let’s talk about what’s making you feel so fearful.” |
C | “I think we need to work on identifying your strengths.” |
D | “Can we talk about this tomorrow at the family meeting?” |
Question 6 |
A client on your unit says the Mafia has a contract out on him. He refuses to leave his semiprivate room and insists on frisking his roommate before allowing him to enter. Which action should the nurse take first?
A | Transfer the client to a private room. |
B | Acknowledge the client’s fear when he refuses to leave his room or wants to frisk his roommate. |
C | Transfer the roommate to another room. |
D | Lock the client out of his room for a while each day so he can see he’s safe. |
Question 7 |
A client with schizotypal personality disorder is sitting in a puddle of urine. He’s playing in it, smiling, and softly singing a child’s song. Which action would be best?
A | Admonish the client for not using the bathroom. |
B | Firmly tell the client that his behavior is unacceptable. |
C | Ask the client whether he’s ready to get cleaned up now. |
D | Help the client to the shower and change the bedclothes. |
Question 8 |
A client with avoidant personality disorder says occupational therapy (OT) is boring and he doesn’t want to go. Which action by the nurse is most appropriate?
A | State firmly that you’ll escort him to OT. |
B | Arrange with OT for the client to do a project on the unit. |
C | Ask the client to talk about why OT is boring. |
D | Arrange for the client not to attend OT until he feels better. |
Question 9 |
Of all of the cluster groupings of personality disorders, which group is apt to be most challenging to the management of the milieu of the unit for the nurse?
A | Cluster A |
B | Cluster B |
C | Cluster C |
D | Cluster D |
Question 10 |
What would be an important guideline for nurses working with clients with borderline personality disorder?
A | When behavioral problems emerge, calmly review the therapeutic goals and boundaries of treatment. |
B | Try to prevent or reduce untoward effects of manipulation. |
C | Remain neutral and avoid engaging in power struggles. |
D | Respect a client’s need for social isolation. |
Question 11 |
A nurse admits a client who has an obsessive-compulsive personality disorder to the unit. The nurse expects this client to be preoccupied with which of the following?
A | Their own attractiveness |
B | Their own needs and desires being met |
C | Rules and regulations of the unit |
D | Isolating from all the other clients on the unit |
Question 12 |
Which of the following nursing diagnoses would be appropriate for a client with an obsessive-compulsive disorder?
A | Disturbed sensory perception related to body illusions experienced |
B | Risk for self-directed violence related to evidence of recent selfmutilation |
C | Risk for injury related to uncontrolled angry outbursts, hitting the wall |
D | Ineffective coping related to indecisiveness and preoccupation with details |
Question 13 |
The nurse recently admitted a client with an obsessive-compulsive personality disorder. What is the most appropriate outcome for this client?
A | Participates in impulse control training |
B | Demonstrates a reduction in clinging, splitting, manipulation, and other distancing behaviors |
C | Demonstrates a decreased suspicion and increased security |
D | Participates in recreational therapy on the unit |
Question 14 |
A nurse is providing care for a client who has obsessive-compulsive disorder. It is important for the nurse to do which of the following?
A | Use a friendly, gentle, reassuring approach because it is the best way to treat clients with an obsessive-compulsive disorder. |
B | Guard against engaging in power struggles with these clients. Their need for control is very high. |
C | Be aware that clients with this personality disorder can instill guilt when they are not getting what they want. |
D | Teach and role model assertiveness. |
Question 15 |
What behaviors would a nurse expect to see in a client who has a schizoid personality disorder?
A | Fearful and anxious |
B | Erratic and emotional |
C | Odd and eccentric |
D | Emotional and dramatic |
Question 16 |
Which of the following behavior patterns would a nurse expect to observe in a client with a schizoid personality disorder?
A | Emotional coldness and flattened affect |
B | Submissive and clinging |
C | Impulsive and unstable emotionally |
D | Cheerful and carefree |
Question 17 |
A client with dependent personality disorder is having trouble performing activities of daily living. Which nursing intervention should help facilitate the client’s daily activities?
A | Have the client eat three meals a day. |
B | Work with the client to establish a budget. |
C | Make a chart to document hygiene practices. |
D | Discuss how the client can obtain a driver’s license. |
Question 18 |
Which of the following behavior patterns would a nurse expect to observe in a client with an obsessive-compulsive personality disorder?
A | Inflexible and lack of spontaneity |
B | Submissive and clinging |
C | Impulsive and unstable emotionally |
D | Cheerful and carefree |
Question 19 |
Which nursing intervention has priority for a client with borderline personality disorder?
A | Maintain consistent, realistic limits. |
B | Give instructions for meeting basic self-care needs. |
C | Engage in daytime activities to stimulate wakefulness. |
D | Have the client attend group therapy on a daily basis. |
Question 20 |
The nurse is identifying nursing outcomes for a client with a schizoid personality disorder. What is the most appropriate outcome?
A | Demonstrates an ability to use constructive criticism |
B | Participates in two of the four scheduled groups on the unit |
C | Demonstrates a reduction in clinging, splitting, and manipulation behaviors |
D | Demonstrates a decrease in attention-seeking behaviors |
Question 21 |
What might be an effective intervention for a client with a schizoid personality disorder?
A | Participates in impulse control training |
B | Participates in anger management classes |
C | Participates in group without being the center of attention |
D | Participates in social skills training |
Question 22 |
A nurse is assessing a client with a narcissistic personality disorder. The nurse anticipates the client’s behavior to be characterized as which of the following?
A | Grandiose and entitled |
B | Submissive and clinging |
C | Impulsive and unstable emotionally |
D | Provocative and seductive |
Question 23 |
A client with dependent personality disorder is working on goals for selfcare. Which short-term goal is most important to the client’s everyday activities of daily living?
A | Do all self-care activities independently. |
B | Write a daily schedule for each day of the week. |
C | Do self-care activities in a minimal amount of time. |
D | Determine activities that can be performed without help. |
Question 24 |
Which of the following nursing diagnoses would be appropriate for a client with a narcissistic personality disorder?
A | Risk for self-mutilation related to a desperate need for attention |
B | Ineffective coping related to negative attitudes toward health behavior |
C | Impaired social interaction related to use of control strategies and disruption of close relationships |
D | Risk for injury related to uncontrolled anger and hostility toward others |
Question 25 |
Which of the following nursing outcomes would be appropriate for a client with a narcissistic personality disorder?
A | Identifies factors that interfere with social interaction |
B | Demonstrates a reduction in clinging and splitting behaviors |
C | Demonstrates ability to reframe negative self-thoughts into more realistic appraisals |
D | Seeks help when experiencing self-destructive impulses |
Question 26 |
Which of the following nursing diagnoses would be appropriate for a client with a schizoid personality disorder?
A | Impaired social interaction related to seductive and self-dramatizing behaviors |
B | Risk for other-directed violence related to pacing and threatening stances |
C | Ineffective coping related to difficulty in developing close relationships |
D | Defensive coping related to absence of guilt and superior attitude toward others |
Question 27 |
Which of the following describes relationships of a client with a histrionic personality disorder?
A | Cold and distant |
B | Shallow and smothering |
C | Close and clingy |
D | Distrustful and jealous |
Question 28 |
Which of the following clients needs to be assigned as a 1:1 with a psychiatric technician?
A | A client with histrionic personality disorder who frequently faints when a male individual is near |
B | A client with antisocial personality disorder who steals food from other clients’ meal trays |
C | A client with an obsessive-compulsive personality disorder who insists all the rules of the unit be followed |
D | A client with borderline personality disorder who has acted on stated suicidal thoughts and has cut herself |
Question 29 |
A client with a dependent personality disorder is taking fluoxetine (Prozac) for depression. Which instruction is included in client teaching?
A | Drink only wine and beer when taking this drug. |
B | Add as-needed doses if depression becomes worse. |
C | Expect 3 to 4 weeks to go by before effects are seen. |
D | Be aware that alterations in usual sleep patterns, especially nightmares, may occur. |
Question 30 |
Which of the following responses would a nurse expect from a client with a narcissistic personality disorder?
A | “You owe me 5 more minutes on my smoke break since you let us out late from group.” |
B | “You are the only nurse that understands me; I don’t like the other nurses at all. They are mean.” |
C | “I don’t know what I should wear today or what groups I should go to.” |
D | “I can’t go to group today because one of the clients hurt my feelings yesterday in group.” |
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