A nurse is reviewing the medical record of a young adult client who has a new diagnosis of borderline personality disorder. Which of the following findings should the nurse identify as risk factors for this disorder? (Select all that apply.)

The client follows a strict routine of daily activities.

The client reports having a substance use disorder.

The client is a twin

The client's mother abandoned him as a child.

The client's father has an impulse control disorder.

Answer and Explanation

Correct Answer : B,D,E

A. The client follows a strict routine of daily activities:
This choice is less likely to be a risk factor for borderline personality disorder. BPD is characterized by impulsivity and difficulties in maintaining stable routines or relationships. Individuals with BPD often struggle with adhering to strict routines due to impulsive behaviors and emotional dysregulation.

B. The client reports having a substance use disorder:
Individuals with borderline personality disorder often struggle with impulse control and emotional regulation. Substance use can be a way for them to cope with intense emotions and mood swings. The presence of a substance use disorder can indicate a higher risk for borderline personality disorder due to these coping mechanisms.

C. The client is a twin:
Being a twin, in itself, is not a direct risk factor for borderline personality disorder. However, if there are genetic or environmental factors contributing to the disorder, both twins might be at risk due to shared genetic material and upbringing. It's essential to consider the specific familial and environmental context when assessing the risk in twins.

D. The client's mother abandoned him as a child:
Early childhood experiences play a significant role in the development of personality disorders, including borderline personality disorder. Abandonment, neglect, or other forms of trauma can disrupt a child's sense of security and trust, leading to difficulties in regulating emotions and forming stable relationships later in life.

E. The client's father has an impulse control disorder:
Growing up in an environment where a parent has an impulse control disorder can create an unstable living situation. Inconsistent parenting and unpredictable behaviors can contribute to emotional instability and difficulties in regulating impulses, which are hallmark features of borderline personality disorder.

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Correct Answer is A

Explanation

A. "This medication is given to help with extrapyramidal side effects."
Benztropine is an anticholinergic medication used to treat the extrapyramidal side effects (EPS) caused by certain psychiatric drugs, particularly antipsychotics. EPS can include symptoms such as muscle stiffness, restlessness, tremors, and other movement disorders. Benztropine helps to alleviate these symptoms, making it an essential medication for individuals experiencing these side effects from antipsychotic medications.

B. "Benztropine helps alleviate your hallucinations."
This statement is incorrect. Benztropine is not primarily used to treat hallucinations; it is used for movement-related side effects as mentioned above.

C. "This medication is given to help with your depression."
This statement is incorrect. Benztropine is not indicated for the treatment of depression.

D. "Benztropine is used to counteract your tachycardia."
This statement is incorrect. Benztropine is not used to treat tachycardia (fast heart rate). It is specifically used for extrapyramidal side effects related to antipsychotic medications.

A. Encourage the client to join group activities. B. Administer methylphenidate to the client. C. Dim the lights in the client's room. D. Provide detailed explanations to the client.

Correct Answer is C

Explanation

A. Encourage the client to join group activities:
Encouraging a client experiencing a manic episode to join group activities is not the best option. Manic episodes are characterized by heightened energy, impulsive behavior, and decreased attention span. Group activities may overstimulate the client, making it difficult for them to focus or participate appropriately. It's essential to minimize stimulation and provide a calm environment to help manage the symptoms of mania.

B. Administer methylphenidate to the client:
Methylphenidate is a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). Administering a stimulant like methylphenidate to a person in a manic state can exacerbate their symptoms. It would increase their already elevated energy levels, restlessness, and impulsivity, making the manic episode more intense and challenging to manage. Using stimulant medications in this context is contraindicated.

C. Dim the lights in the client's room:
Dimming the lights in the client's room is the appropriate choice. Bright lights can increase agitation and restlessness in individuals experiencing a manic episode. Dimming the lights creates a calming environment, reducing excessive stimulation and promoting relaxation. A calm atmosphere is crucial for someone going through a manic episode to help them manage their symptoms effectively.

D. Provide detailed explanations to the client:
During a manic episode, individuals often have racing thoughts and may have difficulty concentrating. Providing detailed explanations can overwhelm the client, as they might have trouble processing complex information in this state. Instead, simple and clear communication is more effective. It's important to provide straightforward instructions and information to prevent further agitation and confusion.

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A nurse is reviewing the medical record of a young adult client who has a new diagnosis of borderline personality disorder. Which of the following findings should the nurse identify as risk factors for this disorder? (Select all that apply.)

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