A nurse is teaching about sources of psychological stress to a group of newly licensed nurses. The nurse should identify which of the following qualifies as a source of psychological distress?

A. Histrionic Personality Disorder:

Individuals with histrionic personality disorder typically seek attention and may be overly dramatic, but self-harm as a response to perceived abandonment is not a characteristic feature.

B. Obsessive-Compulsive Personality Disorder (OCPD):

People with obsessive-compulsive personality disorder are characterized by perfectionism, preoccupation with details, and a desire for control. Michelle's behavior, including self-harm in response to perceived rejection, aligns more closely with borderline personality disorder.

C. Narcissistic Personality Disorder:

While narcissistic individuals may exhibit a sense of superiority and a desire for admiration, self-harm in response to abandonment is not a typical trait of narcissistic personality disorder.

D. Borderline Personality Disorder (BPD):

This personality disorder is characterized by unstable relationships, self-image, and emotions. Individuals with BPD may have intense fears of abandonment and engage in impulsive and self-destructive behaviors. Michelle's perception of being disliked, her claim of superiority, and the self-harming action in response to news of the nurse's vacation are consistent with BPD.

A. Altered thought process related to hallucinations: While altered thought processes are common in manic episodes, hallucinations are not typically associated with mania in Bipolar I disorder. Hallucinations are more commonly seen in psychotic disorders.

B. Risk for violence related to poor impulse control and judgment: This is the correct priority diagnosis. During a manic episode, individuals may have impaired impulse control and poor judgment, increasing the risk of impulsive and potentially violent behaviors. Ensuring the safety of the client and others is the priority.

C. Altered thought process related to poor judgment: While altered thought processes and poor judgment are characteristic of mania, the specific concern in this scenario is the potential for violence. The risk for violence takes precedence as a priority nursing diagnosis.

D. Social isolation related to mania: Social isolation may be a concern, but the immediate priority is addressing the risk for violence, as it poses a more significant threat to the client and others during a manic episode.