A patient with borderline personality disorder has cut her wrists while on the unit. Which of the following is NOT an appropriate nursing intervention?
Devoting extended 1:1 time with the client to vent about their feelings.
Asking the client to write down feelings prior to injury.
Maintaining a neutral tone when assessing the injury.
Helping the patient identify healthy ways to respond to negative emotions.
The Correct Answer is A
A: Devoting extended 1:1 time with the client to vent about their feelings is not appropriate because it can reinforce the behavior by providing attention. It is important to provide support without reinforcing maladaptive behaviors.
B: Asking the client to write down feelings prior to injury is an appropriate intervention as it encourages the patient to express emotions in a non-harmful way.
C: Maintaining a neutral tone when assessing the injury is important to avoid reinforcing the behavior through emotional reactions.
D: Helping the patient identify healthy ways to respond to negative emotions is a key intervention in managing borderline personality disorder and preventing self-harm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A:
This statement describes a behavior more closely associated with bulimia nervosa, where individuals engage in compensatory behaviors such as vomiting to prevent weight gain after overeating. Binge eating disorder (BED) does not involve regular purging behaviors.
Choice B:
This statement indicates a focus on healthy eating and calorie counting, which is not characteristic of binge eating disorder. BED involves episodes of eating large quantities of food with a sense of loss of control, not controlled eating habits.
Choice C:
This statement reflects weight loss and improved body image, which does not align with the symptoms of binge eating disorder. BED is characterized by recurrent episodes of eating large amounts of food and feeling a lack of control over eating.
Choice D:
This statement aligns with the diagnostic criteria for binge eating disorder. Individuals with BED often eat large amounts of food and feel uncomfortably full, accompanied by feelings of disgust or guilt. This behavior is a key indicator of BED, as it involves eating beyond the point of fullness and experiencing negative emotions afterward.
Correct Answer is C
Explanation
A: Circumstantiality involves excessive and unnecessary detail in conversation, eventually reaching the point. It is not related to the content of the client’s statement, which is more about delusional thinking.
B: Echolalia is the repetition of another person’s spoken words. It does not apply to the client’s statement, which is an original delusional claim.
C: Grandiose delusions are false beliefs of exceptional abilities, wealth, or fame. The client’s claim of being the head of the FBI and working with presidents is a clear example of a grandiose delusion, reflecting an inflated sense of self-importance and unrealistic achievements.
D: Depersonalization involves feelings of detachment from oneself, as if observing oneself from outside the body. This symptom does not fit the client’s statement, which is more about delusional beliefs.
E: Magical thinking involves believing that one’s thoughts or actions can influence events in a way that defies the laws of cause and effect. The client’s statement does not reflect magical thinking but rather grandiose delusions.
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