A nurse is interviewing a client who has borderline personality disorder. The nurse and client have agreed on an interview time, but the client resists discussing her feelings until 5 min prior to the end of the session and then asks for additional time. Which of the following actions should the nurse take?
Set an extra meeting time to discuss the client's feelings.
End at the scheduled time, telling the client that she can continue at the next scheduled session.
Arrange for another nurse to continue the interview.
Extend the scheduled time, as the client is finally able to discuss important feelings.
The Correct Answer is B
Choice A reason: Setting an extra meeting time may reinforce manipulative behavior patterns common in borderline personality disorder.
Choice B reason: Ending at the scheduled time maintains boundaries and consistency, which are crucial in managing borderline personality disorder. It teaches respect for limits and prevents manipulation.
Choice C reason: Arranging for another nurse undermines continuity of care and does not address the boundary issue.
Choice D reason: Extending the time reinforces manipulative behavior and undermines therapeutic boundaries.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Encouraging focus on reality-based issues helps redirect the client gently without reinforcing delusions. It maintains therapeutic communication while grounding the client.
Choice B reason: Asking for meaning focuses attention on the delusion, reinforcing it rather than redirecting.
Choice C reason: Persuading the client that thoughts are not true is confrontational and ineffective. Clients with schizophrenia may not accept reality testing when actively delusional.
Choice D reason: Allowing continued delusional talk reinforces psychosis and does not promote reality orientation.
Correct Answer is B
Explanation
Choice A reason: Encouraging the client to argue with voices reinforces the hallucination and is not therapeutic.
Choice B reason: Telling the client the hallucination is not real helps orient them to reality while maintaining empathy. It acknowledges their experience without validating the hallucination.
Choice C reason: Acting as if the hallucination is real reinforces psychosis and is inappropriate.
Choice D reason: Asking direct questions about the hallucination can increase focus on the false perception, worsening symptoms.
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