Answer and Rational Anxiety and Personality Disorder Nclex RN

 Answer and Rational Anxiety and Personality Disorder Nclex RN
01.Answer d
Rational: Clients with borderline personality disorders frequently demonstrate a pattern of unstable interpersonal relationships, impulsiveness, affective instability, and frantic efforts to avoid abandonment; these behaviors usually create great difficulty in establishing mutual goals.

02.Answer: a.
Rational:  Setting limits on manipulative behavior provides the structure that the client needs. Encouraging acting out behavior and allowing the client to set limits would be contraindicated.
The need for restraints in a client with borderline personality disorder would be rare, unless coexisting disorders exist

03.Answer b
Rational: The lack of superego control allows the ego and the id to control the behavior. Self-motivation and self-satisfaction are of paramount concern.

04.Answer: c.
Rational:  A client with panic disorder commonly has feelings of powerlessness and helplessness,and can easily feel out of control.Teaching the client problem-solving and decision-making skills can promote the ability to cope and to have a sense of personal control.A client who experiences panic disorder typically doesn’t tend to engage in high-risk behaviors or have identity problems. A discussion about relationships is premature for this client.

05.Answer c
Rational:  These clients are withdrawn, aloof, and socially distant; allowing distance and providing support may encourage the eventual development of a therapeutic alliance. Group therapy would increase this client’s anxiety; cognitive or behavioral therapy would be more appropriate.

06.Answer: b.
Rational:  The client experiencing a panic attack is unable to focus and his ability to relate to others is diminished; therefore,short, simple sentences are the most effective means of communication. Telling the client that there’s no need to panic or that he’s safe,or offering detailed explanations invalidates
the client’s feelings of anxiety.

07.Answer c .
Rational:  This intervention demonstrates the nurse’s caring presence which is vital for this client. (1) Although the treatment team does need to know about the event, notification is not the immediate concern. (2) This is premature and it reinforces the client’s predisposition to manipulative behavior. (4) This medication is inappropriate in this situation; vomiting would be expected after the ingestion of shampoo.

08.Answer: a.
Rational:  By addressing the client’s actions that interfere with creating social relationships, the nurse can assist the client in becoming aware of the impact of inappropriate behaviors on
others and begin to work on how to prevent them. Talking with the client about following unit rules, encouraging him to change thinking patterns, and telling him that his negative feelings are causing  personality changes don’t address how his spying behavior influences other clients and isolates  him from effectively interacting with peers.

09.Answer c
Rational: Clients with paranoid personality disorder are affectively restricted, appear unemotional, and appear rational and objective.

10.Answer: b.
Rational:  Willingness to risk self-revelation is a characteristic of a healthy interpersonal relationship. Minimal self-revelation is holding back on the relationship. Ego-dystonic behavior refers to thoughts, impulses, attitudes and behavior that the client feels are distressing, repugnant, or inconsistent with the rest of his personality. Intimacy while maintaining separate (rather than merging) identities is a characteristic of a healthy relationship.

11.Answer: a.
Rational:  Pharmacologic management would consist of either tricyclic antidepressants or benzodiazepines. Proton pump inhibitors are used for GI disorders. Nitroprusside is a vasodilator used for hypertensive emergencies. Lithium carbonate is an antimanic agent.

12.Answer a
Rational:  Clients with antisocial personality disorder tend to engage in acts of dishonesty, shown by lying.

13.Answer D.
Rational:  Clients with antisocial personality disorder are often sent for treatment by the court after multiple crimes or for the use of illegal substances.

14.Answer a
Rational: Clients with borderline personality disorder tend to self-mutilate and have abrasions in various stages of healing.

15.Answer: d.
Rational:  Constant patterns of anxiety that affect the client for more than 6 months and interfere with normal activities are characteristic of generalized anxiety disorder.
Pharmaceutical therapy with benzodiaze pines can help. Clients having regular obsessions are probably suffering from obsessivecompulsive disorder. Nightmares and flashbacks are typical symptoms of posttraumatic stress disorder.

16.Answer c
Rational: Chronic feelings of emptiness and sadness predispose a client to depression. About 40% of the clients with borderline struggle with depression.

17.Answer A
Rational:  The family needs information about coping skills to help the client learn to handle stress. Clients with dependent personality disorder don’t have aggressive outbursts; they tend to be passive and submit to others. They don’t tend to have panic attacks. Exercise is a health promotion activity for all clients. Clients with dependent personality disorder wouldn’t need exercise promoted more than other people.

18.Answer: d.
Rational:  Clients who have taken steroids can experience a manic episode. Anticholinergic,vasodilator, and antiemetic drugs don’t induce a manic episode.

19.Answer: a.
Rational:  Keeping messages consistent,fostering trust, and avoiding deception will help to decrease suspiciousness. Encouraging social interactions, attending to basic daily needs, and providing pharmacologic therapy are general nursing interventions that are appropriate for any psychiatric disorder.

20.Answer: d.
Rational:  The nurse should respond in a way that helps the client recognize that the way a person speaks can escalate anger and arouse anxiety and aggressive responses in others. Although the other responses spoken could be true for some clients, they don’t address the client’s acting out verbally and attempting to use aggressive words to intimidate others.

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Anxiety and Personality Disorder Nclex RN Practice Questions

 Anxiety and Personality Disorder Nclex RN Practice Questions
01.When working with the nurse during the orientation phase of the relationship, a client with a borderline personality disorder would probably have the most difficulty in:
a.Controlling anxiety
b.terminating the session on time
c.Accepting the psychiatric diagnosis
d.Setting mutual goals for the relationship

02. A nurse is caring for a client with borderline
personality disorder. Which interventions should the nurse perform?
a. Setting limits on manipulative behavior
b. Allowing the client to set limits
c. Using restraints judiciously
d. Encouraging acting out behavior

03.A person with antisocial personality disorder has difficulty relating to others because of never having learned to:
a.Count on others
b.Empathize with others
c.Be dependent on others
d.Communicate with others socially

04. A client who experiences panic disorder states that he’s frequently overwhelmed by feelings of powerlessness. In working with this client, the nurse should initiate which intervention?
a. Assist the client to recognize unnecessary risk-taking.
b. Explore with the client issues related to identity problems.
c. Teach the client problem-solving and decision-making skills.
d. Have the client discuss the things he desires in a relationship.

05.When caring for a client with a diagnosis of schizotypal personality disorder, the nurse should:
a.Set limits on manipulative behavior
b.encourage participation in group therapy
c.Respect the client’s needs for social isolation
d.Understand that seductive behavior is expected.

06. A nurse is caring for a client who is experiencing a panic attack. Which intervention is most appropriate?
a. Tell the client that there’s no need to panic.
b. Speak in short, simple sentences.
c. Explain that there’s no need to worry.
d. Give the client a detailed explanation of his panic reaction.

07.   An adult client with a borderline personality disorder become nauseated and vomits immediately after drinking after drinking 2 ounces of shampoo as a suicide gesture. The most appropriate initial response by the nurse would be to:
a.Promptly notify the attending physician
b.Immediately initiate suicide precautions
c.Sit quietly with the client until nausea and vomiting subsides
d.Assess the client’s vital signs and administer syrup of ipecac.

08. A nurse notices that a client with paranoid personality disorder demonstrates some instances of spying behaviors on other

clients on the unit. Which nursing intervention should the nurse institute?
a. Address the client’s actions that interfere with creating social relationships.
b. Talk with the client about the need to follow the rules established for the unit.
c. Encourage the client to evaluate and change personal thinking patterns.
d. Tell the client that his negative feelings are causing personality changes.

09.   Which of the following characteristics is expected for a client with paranoid personality disorder who receives bad news?
a. The client is overly dramatic after hearing the facts
b. The client focuses on self to not become over-anxious
c. The client responds from a rational, objective point of view
d. The client doesn’t spend time thinking about the information.

10. A nurse is teaching a client about healthy interpersonal relationships. Which characteristic should the nurse include?
a. Minimal self-revelation
b. Willingness to risk self-revelation
c. Ego-dystonic behavior
d. Intimacy and merging of identities

11. A nurse is caring for a client who reports that she feels a choking sensation in her throat, a racing heart, and fearfulness.
These symptoms have occurred almost daily for the past 3 months. Suspecting a psychological component the nurse anticipates
administering:
a. benzodiazepines.
b. proton pump inhibitors.
c. nitroprusside.
d. lithium carbonate.

12.   A nurse notices other clients on the unit avoiding a client diagnosed with antisocial personality disorder. When discussing appropriate behavior in group therapy, which of the following comments is expected about this client by his peers?
a. Lack of honesty
b. Belief in superstitions
c. Show of temper tantrums
d. Constant need for attention

13.Which of the following characteristics or client histories substantiates a diagnosis of antisocial personality disorder?
a.Delusional thinking
b.Feelings of inferiority
c.Disorganized thinking
d.Multiple criminal charges

14.Which of the following assessment findings is seen in a client diagnosed with borderline personality disorder?
a.Abrasions in various healing stages
b.intermittent episodes of hypertension
c.Alternating tachycardia and bradycardia
d.Mild state of euphoria with disorientation

15. A nurse is caring for a client who has generalized anxiety disorder. Which statement about this client is true?
a. The client has regular obsessions.
b. Relaxation techniques are necessary for cure.
c. Nightmares and flashbacks are common in this client.
d. His anxiety lasts longer than  months.

16.Which of the following conditions is likely to coexist in clients with a diagnosis of borderline personality disorder?
a.Avoidance
b.Delirium
c.Depression
d.Disorientation

17.Which of the following information must be included for the family of a client diagnosed with dependent personality disorder?
a.Address coping skills
b.Explore panic attacks
c.Promote exercise programs
d.Decrease aggressive outbursts

18. A nurse is observing a client on a medical unit who’s pacing the room, shaking his head from side to side, and clasping and
unclasping his hands. As the nurse reviews the client’s health history, she should be alert for information about which medication
that could be linked to the client’s behavior?
a. Anticholinergics
b. Vasodilators
c. Antiemetics
d. Steroids

19. A nurse is caring for a client diagnosed with paranoid personality disorder in an acute care facility. Which intervention should the nurse use to control the client’s suspiciousness?
a. Keeping messages clear and consistent,while avoiding deception
b. Providing pharmacologic therapy
c. Providing social interactions with others on the unit
d. Attending to basic daily needs of the client on a consistent basis

20. A client is court mandated to attend an anger management course. The client uses an aggressive tone to ask the nurse who’s teaching the educational session, “Why can’t I talk the way I want?” Which is the best therapeutic response from the nurse?
a. “Sometimes our words don’t adequately express the point we want to make.”
b. “There’s often a problem when an attitude of superiority is shown to others.”
c. “Tomorrow you may feel differently and you can’t change the way you spoke today.”
d. “The way a person speaks can be a way of acting out intense feelings.”

 Answers & Rationals

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Nclex RN Exams Practice Questions Psychotic Disorders Part 2

1. A nurse is caring for a client with agoraphobia. Which of the following signs and symptoms would the
nurse expect to find in this client? Select all that apply.
a. Hallucinations
b. Panic attacks
c. Inability to leave home
d. Eating disorders
e. Alcohol consumption
f. Tobacco use

2. A client with the nursing diagnosis of Fear related to being embarrassed in the presence of others exhibits
symptoms of social phobia. What nursing outcomes should the nurse establish for this client? Select
all that apply.
a. The client manages her fear in group situations.
b. The client develops a plan to avoid situationsthat may cause stress.
c. The client verbalizes feelings that occur in stressful situations.
d. The client develops a plan for responding to stressful situations.
e. The client denies feelings that may contribute to irrational fears.
f. The client uses suppression to deal with underlying fears.


3. A nurse is caring for a client diagnosed with dysthymia.Which of the following defining characteristics
are associated with this disorder? Select all that apply.
a. Insomnia or hypersomnia
b. Delusions or hallucinations
c. Suicidal thoughts
d. Onset of symptoms within a 2-week period
e. Symptoms that occur in the winter and resolve in spring
f. Appetite disturbance

4. A nurse interviews the family of a client hospitalized with severe depression and suicidal ideation.
What family assessment information is essential to know when formulating an effective plan of care?
Select all that apply.
a. Physical pain
b. Personal responsibilities
c. Employment skills
d. Communication patterns
e. Role expectations
f. Current family stressors

5. A client has been diagnosed with an adjustment disorder with mixed anxiety and depression. What are
the primary nursing diagnoses the nurse would associate with this type of adjustment disorder? Select all
that apply.
a. Activity intolerance
b. Impaired social interaction
c. Risk for situational low self-esteem
d. Disturbed personal identity
e. Acute confusion
f. Impaired memory

6. A delusional client says to a nurse “I am the Easter bunny,” and insists that the nurse refer to him as
such. The belief appears to be fixed and unchanging.Which of the following nursing interventions should
the nurse implement when working with this client?Select all that apply.
a. Consistently use the client’s name in interactions.
b. Smile at the humor of the situation.
c. Agree that the client is the Easter bunny.
d. Logically point out why the client couldn’t be the Easter bunny.
e. Provide an as-needed medication.
f. Provide the client with structured activities.

7. The nurse is assessing a 25-year-old man who is a polysubstance abuser, with cocaine being his drug of
choice. Which of the following physiological symptoms is suggestive of cocaine intoxication? Select all that
apply.
a. Respiratory depression
b. Psychomotor agitation
c. Cardiac arrhythmias
d. Dilated pupils
e. Projectile vomiting
f. Slurred speech

8.A nurse is monitoring a client receiving tranylcypromine sulfate (Parnate). Which serious adverse reaction can occur with high dosages of this monoamine oxidase (MAO) inhibitor?
a.Hypotensive episodes
b.Hypertensive crisis
c.Muscle flaccidity
d.Hypoglycemia

9.A client was talking with her husband by telephone, and then she began swearing at him. The nurse interrupts the call and offers to talk with the client. She says, "I can't talk about that bastard right now. I just need to destroy something." Which of the following should the nurse do next?
a.Tell her to write her feelings in her journal.
b.Urge her to talk with the nurse now.
c.Ask her to calm down or she will be restrained.
d.Offer her a phone book to "destroy" while staying with her.

10.The mother of a client with chronic undifferentiated schizophrenia calls the visiting nurse in the outpatient clinic to report that her daughter has not answered the phone in 10 days. "She was doing so well for months. I don't know what's wrong. I'm worried." Which of the following responses by the nurse is most appropriate?
a."Maybe she's just mad at you. Did you have an argument?"
b."She may have stopped taking her medications. I'll check on her."
c."Don't worry about this. It happens sometimes."
d."Go over to her apartment and see what's going on."
Answer and Rational

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