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 D

Explanation

A. Having an advanced degree in engineering:

While pursuing an advanced degree can be challenging, it is not inherently a source of psychological distress. It may represent a personal and professional accomplishment.

B. Attending a community center daily:

Attending a community center daily is a regular activity and may not necessarily be a source of psychological distress. It could be a positive and fulfilling aspect of one's routine.

C. Belonging to the middle-class socioeconomic group:

Belonging to the middle-class socioeconomic group is not inherently a source of psychological distress. Socioeconomic status alone does not determine psychological well-being, and being in the middle class can provide stability and resources.

D. Being the only person of their ethnicity in a school setting:

This qualifies as a source of psychological distress. Being the only person of a particular ethnicity in a school setting may lead to feelings of isolation, cultural dissonance, and a sense of being different. Such situations can contribute to psychological distress and impact mental well-being.

A. A client diagnosed I with hypomania who is speaking loudly on the unit. B. A client diagnosed with hypomania who is complaining of pain. C. A client with a history of mania who is pacing in the hallway D. A client diagnosed with mania who expressed active suicidal ideations

Correct Answer is D

Explanation

A. A client diagnosed with hypomania who is speaking loudly on the unit: Hypomania involves elevated mood and increased activity, but it doesn't typically present an immediate risk of harm to self or others. While it may be disruptive, it doesn't have the same urgency as active suicidal ideation.

B. A client diagnosed with hypomania who is complaining of pain: Pain complaints should be addressed, but in the context of the given choices, it is not the highest priority. Assessing and addressing the potential for harm due to active suicidal ideation is more critical.

C. A client with a history of mania who is pacing in the hallway: Pacing in the hallway, while indicative of increased activity, does not necessarily indicate an immediate risk. The client expressing active suicidal ideations poses a more urgent concern that requires immediate attention.

D.A client diagnosed with mania who expressed active suicidal ideations

In determining priority, the nurse should consider the level of risk and the potential for harm to self or others. Suicidal ideation is a significant concern that requires immediate attention. A client expressing active suicidal thoughts poses an immediate risk to their safety.

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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

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Explanation

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Correct Answer is D

Explanation

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