A nurse is contributing to the plan of care for a client who has borderline personality disorder.
Which of the following interventions should the nurse recommend?

Encourage the client to communicate with staff when feeling urges for self-harm.

Assist the client in developing healthy coping mechanisms for intense emotions.

Advise the client to avoid expressing their feelings assertively.

Offer the client additional attention only when self-mutilating behaviors occur.

Answer and Explanation

Correct Answer : A,B

Choice A rationale

Encouraging communication with staff during self-harm urges is a crucial intervention for clients with borderline personality disorder. This allows for immediate support, redirection of focus, and the opportunity to implement coping strategies before an episode of self-harm occurs, aligning with the principles of dialectical behavior therapy often used for this disorder.

Choice B rationale

Assisting the client in developing healthy coping mechanisms for intense emotions is fundamental in managing borderline personality disorder. Individuals with this disorder often experience emotional dysregulation, and learning adaptive coping skills provides them with tools to manage distress, reduce impulsivity, and decrease the likelihood of self-harm.

Choice C rationale

Advising the client to avoid expressing feelings assertively is countertherapeutic. Clients with borderline personality disorder may struggle with expressing emotions appropriately. Encouraging avoidance can lead to suppressed feelings, potential emotional outbursts, and increased risk of self-harm. Assertive communication skills should be fostered.

Choice D rationale

Offering additional attention only when self-mutilating behaviors occur can inadvertently reinforce these behaviors. This approach can create a pattern where the client engages in self-harm to gain attention, rather than learning healthier ways to seek support and manage their emotions. Consistent and proactive support is more effective.

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Correct Answer is C

Explanation

Choice A rationale

Assisting the client with evaluating their coping mechanisms is a helpful strategy for preventing future panic attacks and managing anxiety in the long term. However, during an acute panic attack, the client's ability to think rationally and evaluate their coping skills is significantly impaired. The immediate focus should be on reducing overwhelming stimuli.

Choice B rationale

Exploring with the client what precipitates an attack is crucial for identifying triggers and developing preventative strategies. However, during an active panic attack, the client is experiencing intense anxiety and may not be able to effectively process or articulate potential triggers. This intervention is more appropriate for periods between attacks.

Choice C rationale

Minimizing environmental stimuli is a key intervention during a panic attack. Panic attacks involve a surge of intense fear and anxiety, often accompanied by sensory overload. Reducing noise, bright lights, and excessive activity in the immediate surroundings can help decrease the client's distress and promote a sense of calm and safety.

Choice D rationale

Encouraging the client to set goals is a therapeutic strategy aimed at promoting a sense of control and accomplishment, which can be beneficial for overall mental health and managing anxiety in the long term. However, during an acute panic attack, the client is likely overwhelmed and unable to focus on goal setting. The immediate priority is to reduce their acute anxiety.

A. Client denies that substance use was triggered by any childhood trauma. B. Client states that they “just got in with the wrong set of friends.” C. Client has identified several coping mechanisms when they feel tempted to use the substances. D. Client is not sure where they will live after discharge. E. Client states that they are looking forward to seeing old friends when they are released from the hospital. F. Client states that they have a plan to receive their methadone daily following discharge. G. The client has written a plan for what to do if relapse should occur. H. Client states that they are willing to participate in outpatient therapy following discharge.

Correct Answer is ["C","F","G","H"]

Explanation

The statements that indicate the client is progressing as expected include:

Client has identified several coping mechanisms when they feel tempted to use substances.
Client has written a plan for what to do if relapse should occur.
Client states that they are willing to participate in outpatient therapy following discharge.
Client states that they have a plan to receive their methadone daily following discharge.

These statements demonstrate the client’s ability to recognize and implement strategies for managing cravings, their proactive approach to relapse prevention, and their willingness to continue treatment after discharge—all signs of expected progress in recovery. However, uncertainty about post-discharge living arrangements and eagerness to reconnect with old friends could present challenges, as returning to previous environments may increase relapse risk. Continued support and planning are essential for a successful transition.

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A nurse is contributing to the plan of care for a client who has borderline personality disorder.Which of the following interventions should the nurse recommend?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client who experiences panic attacks.Which of the following strategies should be included for implementation during an attack?

Correct Answer is C

Explanation

Correct Answer is ["C","F","G","H"]

Explanation

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A nurse is contributing to the plan of care for a client who has borderline personality disorder.
Which of the following interventions should the nurse recommend?