A 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?

Maintain consistency of care by open communication to avoid staff manipulation

Maintain unit order by the application of autocratic leadership

Allow the clients to apply the democratic process when developing unit rules

Allow the client spokesperson to verbalize concerns during a unit staff meeting

Answer and Explanation

The Correct Answer is A

A. Maintain consistency of care by open communication to avoid staff manipulation: This is the correct answer. Borderline personality disorder (BPD) clients may engage in splitting behaviors, which involve polarized views of staff as either all good or all bad. Maintaining consistency of care and open communication can help prevent manipulation and ensure fair and transparent interactions.

B. Maintain unit order by the application of autocratic leadership: Autocratic leadership, characterized by a top-down approach with limited input from others, may not be the most effective strategy in this situation. It may lead to resistance from clients and potentially escalate the conflict.

C. Allow the clients to apply the democratic process when developing unit rules: While democratic processes are generally beneficial, allowing clients to unreasonably demand modifications of unit rules without considering the overall impact on the therapeutic environment may not be appropriate. It's important to balance client involvement with maintaining a structured and therapeutic milieu.

D. Allow the client spokesperson to verbalize concerns during a unit staff meeting: While it's important to provide a platform for clients to express concerns, allowing a spokesperson to verbalize concerns during a staff meeting should be done in a manner that maintains order and follows the therapeutic goals of the unit. It should not involve unreasonably demanding modifications without a careful consideration of the impact on the overall treatment milieu.

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Correct Answer is ["B","C","D"]

Explanation

A. Challenge the patient at all times and remain in control of the situation:

Explanation: While maintaining a therapeutic boundary and structure is essential, challenging the patient at all times may lead to resistance or defensiveness. Collaborative and supportive approaches are often more effective than confrontational ones.

B. Provide clear and straightforward communication:

Explanation: Individuals with personality disorders may struggle with interpersonal relationships and communication. Clear and straightforward communication helps to minimize misunderstandings and establish a therapeutic environment.

C. Hold persons accountable for their actions:

Explanation: Accountability promotes responsibility and encourages individuals with personality disorders to take ownership of their behaviors. Setting clear expectations and consequences can be beneficial in fostering a sense of responsibility.

D. Remain consistent:

Explanation: Consistency in approach, rules, and expectations is crucial when working with individuals with personality disorders. It helps establish a stable and predictable environment, promoting a sense of security for the individual.

E. Avoid being too nice or friendly:

Explanation: Avoiding being too nice or friendly doesn't mean being unkind or dismissive. A balanced and professional approach, combining empathy with clear boundaries, is more beneficial. Being overly nice or friendly may blur professional boundaries and hinder therapeutic progress.

A. Teaching clients about their illness B. Maintaining safety on the milieu C. Prescribing medications D. Administering medications

Correct Answer is C

Explanation

A. Teaching clients about their illness: This function is within the scope of practice for both registered nurses and advanced practice psychiatric nurses. Registered nurses often provide education to clients about their illnesses, medications, and overall care.

B. Maintaining safety on the milieu: Both registered nurses and advanced practice psychiatric nurses are responsible for maintaining safety on the milieu. This includes monitoring the environment, assessing potential risks, and intervening to ensure the safety of clients and staff.

C. Prescribing medications: This function is exclusive to advanced practice psychiatric nurses, such as psychiatric nurse practitioners. Registered nurses do not have the authority to prescribe medications. Advanced practice psychiatric nurses receive additional education and training that allows them to prescribe medications as part of their role.

D. Administering medications: Registered nurses, including those specializing in psychiatric nursing, are authorized to administer medications. This is a common nursing function and does not require advanced practice authorization.

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A 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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When working with individuals who have a personality disorder. The nurse is aware of the importance of incorporating which nursing measures. (Select all that apply).

Correct Answer is ["B","C","D"]

Explanation

Within the nurse's scope of practice, which function is exclusive to the advanced practice psychiatric nurse?

Correct Answer is C

Explanation

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