Your patient has been admitted with a diagnosis of bilateral pneumonia. You have trouble communicating with this patient, who is pouty and demanding your constant attention. She talks for long periods about the smallest details of her life. Besides the pneumonia, you ask the physician if the patient has a history of which of the following personality disorders?

Choice A reason: Bursting open of the wound is a description that could imply evisceration, but it is not as specific as choice D.

Choice B reason: Wound edges not approximating is a general description of a wound that is not healing properly, but does not specifically describe evisceration.

Choice C reason: Opening of the wound could refer to any situation where a wound has opened, not necessarily evisceration.

Choice D reason: Evisceration specifically refers to the viscera spilling out of the abdomen, usually through a surgical wound.

Choice A reason: While relaxation techniques are beneficial, providing structure is often the first step in helping clients with OCD manage their symptoms, as it can reduce anxiety and prevent time for obsessions and compulsions to occur.

Choice B reason: A structured schedule can help the client focus on tasks and activities, reducing the time available for obsessive thoughts and compulsive behaviors.

Choice C reason: Identifying expectations is important, but it should come after establishing a structured routine that can support the client's participation in care.

Choice D reason: Discussing alternative coping strategies is a part of treatment, but initially providing a structured schedule can offer immediate relief and a sense of control for the client.