67 notecards = 17 pages (4 cards per page)
totality of emotions and behavioral characteristics that are particular to a specific person and that remains somewhat stable and predictable over time
characteristics that a person is born with or develops early in life. stable over time
when do personality disorders occur?
when traits become inflexible and rigid
paranoid personality disorder
mistrust of others
suspicious and always on guard
oversensitive and insensitive to others
inability to form personal relationships
fails to respond to others in a meaningful way
lacked a nurturing childhood
1.When assessing a client diagnosed with narcissistic personality
disorder, the nurse
grandiose feelings of self importance
graver than schizoid
under stress they may experience psychotic symptoms
disregards the rights of others
fails to conform to the law
borderline personality disorder
fluctuating extreme attitudes
lacks clear sense of identity
excitable, emotional, colorful, dramatic, extroverted
more common in women. 2-3% of the population
exaggerated sense of self worth
lack of empathy
more common in men than women
extremely sensitive to rejection/ socially withdrawn
awkward and uncomfortable in social situations
lonely and feels unwanted
2.A client diagnosed with a personality disorder is cold, aloof, and avoids others on the unit. The nurse recognizes that this behavior is symptomatic of which personality disorder?
A.Schizoid personality disorder
B.Dependent personality disorder
C.Borderline personality disorder
D.Antisocial personality disorder
relies on others for emotional support
more common in women and more common in the youngest child
lack of self confidence: evidenced in voice, posture, and mannerisms
obsessive compulsive disorder
inflexibility in the way things are done.
more common in men and the oldest child in a family
on the surface: calm and controlled. underneath: conflict
why is it called "borderline" personality?
between neuroses and psychosis
characteristics of borderline personality disorder
▪Inability to be alone
▪Clinging and distancing behaviors
predisposing factors of personality disorder
▪Biochemical: Possible serotonergic defect
▪Genetic: Possible familial connection with depression
▪Childhood trauma and abuse
Fixed in the rapprochement phase of development (16 to 24 months old). The child fails to achieve task of autonomy
A client diagnosed with borderline personality disorder is admitted to a psychiatric unit. Which behavior pattern would the nurse expect to observe?
B.Suspiciousness of others
C.Bizarre speech patterns
D.Generates conflict among the staff
d-they have "splitting" behaviors which causes conflict
In assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to observe?
C.Little tolerance for being alone
D.Stable and satisfactory relationships
they do not like to be alone
borderline personality disorder diagnosis
Risk for Suicide
risk for self mutilation
impaired social interaction
Disturbed personal identity related to underdeveloped ego
Anxiety (severe to panic) related to unconscious conflicts based on fear of abandonment
¡Chronic low self-esteem related to lack of positive feedback
nursing implementation for a patient with Borderline personality
confront internalized anger to help develop the personality
why is antisocial disorder not seen in clinical settings?
usually in jail/prison
predisposing factors of antisocial personality disorder
An individual, with a history of antisocial personality disorder, was
arrested for driving
A.“It's not my fault.”
B.“I'm too ashamed to talk about it.”
C.“I just don't remember doing it.”
D.“I'm really sorry about all the people I've hurt.”
a- they lack remorse
interventions for antisocial personality disorder
how to treat personality disorder
¡Milieu or Group Therapy
¡Dialectical Behavior Therapy
ritualistic behaviors- diagnosis
A psychiatrist prescribes an anti-obsessional agent for a client who is using ritualistic behavior. A common anti-anxiety medication used for this type of client would be:
A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit’s rules. This behavior should be confronted because it will help the client:
make the patient aware of the problem
The client with antisocial personality disorder:
A person with antisocial personality disorder has difficulty relating to others because of never having learned to
empathize with others
antisocial client asks for the nurse's phone number. What do you do?
say, "i like you but our relationship is professional".
During an assessment interview, a client diagnosed with antisocial
personality disorder spits, curses, and refuses to answer questions.
Which is the most appropriate nursing statement to address this
A client diagnosed with antisocial personality disorder comes to a
nurses' station at 11:00 p.m. requesting to phone a lawyer to discuss
filing for a divorce. The unit rules state that no phone calls are
permitted after 10:00 p.m. Which nursing reply is most
A client diagnosed with paranoid personality disorder becomes violent
on a unit. Which nursing intervention is most appropriate?
A highly emotional client presents at an outpatient clinic
appointment wearing flamboyant attire, spiked heels, and theatrical
makeup. Which personality disorder should a nurse associate with this
A client diagnosed with borderline personality disorder brings up a
conflict with the staff in a community meeting and develops a
following of clients who unreasonably demand modification of unit
rules. How can the nursing staff best handle this situation?
Which nursing approach should be used to maintain a therapeutic
relationship with a client diagnosed with borderline personality
Which adult client should a nurse identify as exhibiting the
characteristics of a dependent personality disorder?
A pessimistic client expresses low self-worth, has much difficulty
making decisions, avoids positions of responsibility, and has a
behavioral pattern of "suffering" in silence. Which
underlying cause of this client's personality disorder should a nurse
Family members of a client ask a nurse to explain the difference
between schizoid and avoidant personality disorders. Which is the
appropriate nursing reply?
During an interview, which client statement indicates to a nurse that
a potential diagnosis of schizotypal personality disorder should be
A nursing instructor is teaching students about clients diagnosed
with histrionic personality disorder and the quality of their
relationships. Which student statement indicates that learning has
Which nursing diagnosis should a nurse identify as appropriate when
working with a client diagnosed with schizoid personality
When planning care for a client diagnosed with borderline personality
disorder, which self-harm behavior should a nurse expect the client to
Which client situation should a nurse identify as reflective of the
impulsive behavior that is commonly associated with borderline
Which nursing diagnosis should be prioritized when providing care to
a client diagnosed with paranoid personality disorder?
From a behavioral perspective, which nursing intervention is most
appropriate when caring for a client diagnosed with borderline
A nurse tells a client that the nursing staff will start alternating
weekend shifts. Which response should a nurse identify as
characteristic of clients diagnosed with obsessive-compulsive
Looking at a slightly bleeding paper cut, the client screams,
"Somebody help me, quick! I'm bleeding. Call 911!" A nurse
should identify this behavior as characteristic of which personality
Which reaction to a compliment from another client should a nurse
identify as a typical response from a client diagnosed with avoidant
Which client symptoms should lead a nurse to suspect a diagnosis of
obsessive-compulsive personality disorder?
Which client is a nurse most likely to admit to an inpatient facility
for self-destructive behaviors?
When planning care for clients diagnosed with personality disorders,
what should be the anticipated treatment outcome?
The nurse plans to confront a client about secondary gains related to
extreme dependency on spouse. Which nursing statement would be most
The nurse should recognize which factors that distinguish personality disorders from psychosis?
A. Functioning is more limited in personality disorders than in
Which client statement would demonstrate a common characteristic of
Cluster "B" personality disorder?
When a client on an acute care psychiatric unit demonstrates
behaviors and verbalizations indicating a lack of guilt feelings,
which nursing intervention would help the client to meet desired
Which characteristics should a nurse recognize as being exhibited by
individuals diagnosed with any personality disorders?
A nurse would expect a client diagnosed with schizotypal personality
disorder to exhibit which characteristic?
c- "magical thinking" and possibly psychosis under stress
While improving, a client demands to have a phone installed in the
intensive care unit (ICU) room. When a nurse states, "This is not
allowed. It is a unit rule." The client angrily demands to see
the doctor. Which approach should the nurse use in this
Which nursing statement reflects a common characteristic of a client
diagnosed with paranoid personality disorder?
A client exhibits dependency on staff and peers and expresses fear of
abandonment. Using Mahler's theory of object relations, which should
the nurse expect to note in this client's childhood?
A client diagnosed with cluster "C" traits sits alone and
ignores other's attempts to converse. When ask to join a group the
client states, "No thanks." In this situation, which should
the nurse assign as an initial nursing diagnosis?
Which statements represent positive outcomes for clients diagnosed
with narcissistic personality disorder? (Select all that
A nurse is caring for a group of clients within the DSM-IV-TR cluster
B category of personality disorders. Which factors should the nurse
consider when planning client care? (Select all that apply.)