A nurse is discussing borderline personality disorder and the risk for self-harm with a newly licensed nurse. Which of the following situations should the nurse identify as the highest risk for self-harm?

When discharged from the hospital

When attending dialectical behavior therapy

When attending narrative therapy

When getting married

Answer and Explanation

The Correct Answer is A

A. Individuals with borderline personality disorder (BPD) often experience intense and unstable emotions, impulsivity, and difficulties in regulating their emotions and behaviors. As a result, transitions, such as being discharged from the hospital, can be particularly challenging and may increase the risk of self-harm or suicidal behavior.

B. While dialectical behavior therapy (DBT) is an evidence-based treatment for BPD and focuses on teaching coping skills to manage emotions and reduce self-harming behaviors, attending therapy sessions may actually decrease the risk of self-harm for individuals actively participating in treatment.

C. Narrative therapy is another therapeutic approach that focuses on helping individuals reframe their life stories and experiences. While narrative therapy may be beneficial for some aspects of BPD treatment, it may not specifically address the immediate risk factors for self-harm.

D. Getting married may be a significant life event that brings about both positive and negative emotions, but it does not inherently indicate the highest risk for self-harm in individuals with BPD.

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Correct Answer is C

Explanation

C. Reinforcing teaching with vulnerable clients about strategies to prevent illness and promote health is the most immediate and direct action the nurse can take. Education empowers

individuals to make informed decisions about their health and well-being, potentially preventing illness and reducing the need for healthcare services.

A. This action focuses on improving access to care but may not directly address the immediate health needs of vulnerable clients.

B. Protecting the rights and well-being of clients without housing is important, but it may take time to implement legislative changes and see the effects.

D. While advocating for policy change and advising elected officials on the needs of vulnerable populations is important for systemic change, it may not directly address the immediate health needs of vulnerable clients

A. Benzodiazepines B. Sertraline C. Amphetamines D. Antihistamines

Correct Answer is D

Explanation

D Antihistamines, particularly those with strong anticholinergic properties, are known to be associated with the development of delirium. Anticholinergic medications can disrupt neurotransmitter signaling in the brain, leading to cognitive impairment, confusion, and delirium.

A. Benzodiazepine have not been associated with delirium.

B. SSRIs can have side effects, including agitation or confusion in some individuals, they are not typically associated with the development of delirium to the same extent as benzodiazepines.

C. Amphetamines are stimulant medications that increase the activity of certain neurotransmitters in the brain. However, they are not typically associated with the development of delirium.

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A nurse is discussing borderline personality disorder and the risk for self-harm with a newly licensed nurse. Which of the following situations should the nurse identify as the highest risk for self-harm?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for clients who are members of vulnerable populations. Which of the following core function assurance actions should the nurse take first?

Correct Answer is C

Explanation

A nurse is reviewing the medical record of a client who is experiencing delirium. Which of the following medications should the nurse identify as a cause of this disorder?

Correct Answer is D

Explanation

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