A nurse is planning overall strategies to address problems for a client who has borderline personality disorder. Which of the following strategies is the priority for the nurse to incorporate in the plan of care?

Implement measures to prevent intentional self-inflicted injury.

Discuss the appropriate use of assertive behavior with the client.

Encourage the client to attend weekly support group meetings.

Assist the client to maintain awareness of her thoughts and feelings.

Answer and Explanation

The Correct Answer is A

A. Implement measures to prevent intentional self-inflicted injury:
This choice is the priority. Individuals with borderline personality disorder are at an increased risk of self-harm and suicidal behaviors. Implementing measures to prevent intentional self-inflicted injury, such as close monitoring, removing potentially harmful objects, and creating a safe environment, is crucial to ensuring the client's safety and well-being.

B. Discuss the appropriate use of assertive behavior with the client:
Teaching assertive behavior is an important aspect of therapy for individuals with borderline personality disorder. Learning to express emotions and needs in a healthy, assertive manner can improve their interpersonal skills and relationships. However, this choice is secondary to ensuring the client's safety. Safety concerns need to be addressed before moving on to other therapeutic interventions.

C. Encourage the client to attend weekly support group meetings:
Support group meetings can provide valuable social support and a sense of belonging for individuals with borderline personality disorder. Being part of a supportive community can offer understanding and coping strategies. While this is a beneficial intervention, it is not the priority. Safety concerns and addressing self-harm risk take precedence.

D. Assist the client to maintain awareness of her thoughts and feelings:
Developing self-awareness and emotional regulation skills is essential in managing borderline personality disorder. Techniques such as mindfulness and dialectical behavior therapy (DBT) can help individuals become more aware of their thoughts and emotions. While important for long-term management, this intervention is not the priority when immediate safety concerns are present. Safety should always be the first focus of care.

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Correct Answer is D

Explanation

A. "Talking about the traumatic experience is recommended."
This statement is generally correct. Many therapeutic approaches for PTSD, such as cognitive-behavioral therapy (CBT) and exposure therapy, involve talking about the traumatic experience in a controlled and supportive environment. However, the timing and method of discussing the trauma should be guided by a mental health professional.

B. "Response prevention is an effective treatment for PTSD."
This statement is incorrect. Response prevention is a therapeutic technique often used in the treatment of anxiety disorders like obsessive-compulsive disorder (OCD). It involves preventing the usual response to a trigger. However, for PTSD, exposure therapy, cognitive restructuring, and EMDR (Eye Movement Desensitization and Reprocessing) are more common therapeutic approaches.

C. "You should try to limit the number of hours that you sleep each day."
This statement is incorrect. Adequate sleep is crucial for overall mental and physical health, and disrupting sleep patterns can worsen symptoms of PTSD. Sleep disturbances are common in PTSD, and part of managing the disorder often involves addressing sleep problems.

D. "Avoiding stimuli that trigger memories of the trauma can help you overcome your PTSD."
This statement is generally correct. Avoiding triggers that bring back memories of the trauma is a common coping strategy. However, while avoidance might provide short-term relief, it's not a long-term solution. Evidence-based therapies often involve confronting and processing these triggers in a safe and controlled way, under the guidance of a therapist.

A. Withholding a prescribed medication that is causing adverse effects for the client B. Educating the client about legal rights concerning treatment C. Providing the client with quality care regardless of ability to pay for treatment D. Being truthful with the client about the manifestations of withdrawal.

Correct Answer is A

Explanation

A. Withholding a prescribed medication that is causing adverse effects for the client
The principle of nonmaleficence, often summarized as "do no harm," emphasizes the nurse's duty to prevent harm and to remove existing harm. If a medication prescribed to a client is causing adverse effects, the nurse should withhold the medication to prevent harm to the client.

B. Educating the client about legal rights concerning treatment
Educating the client about their legal rights falls under providing information and ensuring the client's autonomy but does not directly address the principle of non-maleficence.

C. Providing the client with quality care regardless of ability to pay for treatment
Providing quality care regardless of the client's ability to pay is an ethical practice, but it aligns more with the principles of justice and beneficence rather than nonmaleficence.

D. Being truthful with the client about the manifestations of withdrawal
Being truthful and providing accurate information to the client about withdrawal symptoms is crucial, but it doesn't directly address the principle of nonmaleficence.

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A nurse is planning overall strategies to address problems for a client who has borderline personality disorder. Which of the following strategies is the priority for the nurse to incorporate in the plan of care?

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