A nurse is caring for a client who has borderline personality disorder.
Which of the following actions should the nurse take?
Provide consistent boundaries for the client.
Encourage the use of countertransference for the client.
Maintain consistency in assigning healthcare staff for the client.
Demonstrate a sympathetic attitude toward the client when providing care.
The Correct Answer is A
Choice A rationale:
Individuals with borderline personality disorder often have difficulty establishing and maintaining boundaries. Providing consistent and clear boundaries helps in promoting a structured and safe environment for the client.
Choice B rationale:
Encouraging the use of countertransference is not appropriate. Countertransference refers to the therapist or nurse's emotional reactions to the client, and it is generally not encouraged as a therapeutic approach.
Choice C rationale:
Maintaining consistency in assigning healthcare staff for the client is essential in promoting stability and reducing anxiety. This is a crucial aspect of care for clients with borderline personality disorder.
Choice D rationale:
Demonstrating a sympathetic attitude is important in providing compassionate care, but it should be balanced with maintaining professional boundaries and not allowing manipulation by the client. Sympathy alone may not be sufficient in effectively managing the client's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is Choice A: Consult the client.
Choice A rationale:
Consulting the client is the most appropriate action to respect their privacy and autonomy. It ensures that the client has control over their health information and consents to any disclosures.
Choice B rationale:
Consulting the client's family is not appropriate without the client's explicit permission, as it may violate the client's right to confidentiality.
Choice C rationale:
Contacting the provider may be helpful for clinical guidance, but they cannot disclose the client's health information without the client's consent.
Choice D rationale:
Contacting the facility legal department would be necessary in specific legal situations, but the first step should be to involve the client in the decision-making process to respect their rights.
Correct Answer is D
Explanation
Choice A rationale:
"I'll take my medicine at bedtime because it will make me drowsy.”. This statement is not accurate and indicates a misunderstanding of the medication's effects. Methylphenidate, used to treat ADHD, is a stimulant medication and is not expected to cause drowsiness. Taking it at bedtime could interfere with the client's ability to sleep.
Choice B rationale:
"I need to tell my doctor if I start gaining weight.”. While it is important to report changes in weight to the healthcare provider, this statement does not indicate an accurate understanding of the medication's effects. Weight gain is not a typical side effect of methylphenidate, and this statement does not address the medication's primary purpose.
Choice C rationale:
"This medicine will help me relax and feel less anxious.”. This statement is incorrect as methylphenidate is not an anxiolytic medication. It is used to increase focus and reduce hyperactivity in individuals with ADHD. While some clients may experience a sense of calm as a result of improved focus, the primary purpose of the medication is not to reduce anxiety.
Choice D rationale:
"I know that I will be able to think more clearly now.”. This statement reflects an accurate understanding of the medication's effects. Methylphenidate is a central nervous system stimulant that can help individuals with ADHD improve their focus, attention, and cognitive function. Enhanced clarity of thought is one of the intended therapeutic effects of this medication. .
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