Chapter 14: Personality Disorders My Nursing Test Banks

Chapter 14: Personality Disorders

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Patients with antisocial personality disorder:

A.

Generally must have immediate gratification.

B.

Display a great deal of responsibility toward others.

C.

Display a great deal of anxiety.

D.

Have obsessive thoughts when in a social situation.

____ 2. Barbara is a new patient on your floor who is being assessed for several disorders, including suicide potential. You learn she attempts suicide every 6 to 12 months because she cannot tolerate living alone. She is unable to see two sides of a situation or an individual; they are either all good or all bad. You consider which of the following as a potential diagnosis for Barbara?

A.

Borderline personality disorder

B.

Multiple personality disorder

C.

Narcissistic personality disorder

D.

Antisocial personality disorder

____ 3. A nice-looking male patient is making suggestive comments to the female nursing staff. When he asks you for your phone number, you therapeutically respond:

A.

I do not believe in dating patients.

B.

It is against the rules for me to date patients.

C.

Ill think about it and let you know.

D.

You are very nice but our relationship is a professional one only.

____ 4. When planning care for an individual with borderline personality disorder, nurses realize that the patient:

A.

Will not be able to make decisions.

B.

Will expect special treatment.

C.

Will act out when feeling afraid or disrespected.

D.

Will withdraw and become uncommunicative.

____ 5. A patient with borderline personality disorder approaches you and voices concern that she is being ignored and feels unimportant. The patient blames the nursing staff for these feelings because the nurses are not paying attention to her. Your best therapeutic response to this patient is:

A.

I will bring it up at our next meeting.

B.

Its all in your imagination.

C.

Tell me more about your feeling of being ignored.

D.

You need to share your feelings with the individual nurses you feel are ignoring you.

____ 6. The main mechanism used by patients who have personality disorders is:

A.

Projection.

B.

Manipulation.

C.

Introjection.

D.

Repression.

____ 7. Nurses understand that a major cause of personality disorders is:

A.

Neurochemical imbalance.

B.

Genetics.

C.

Dysfunctional family relationships.

D.

Anoxia.

____ 8. Nurses know that when working with patients who have personality disorders, the most difficult task for these patients will probably be:

A.

Following rules.

B.

Getting along with others.

C.

Hoarding their medications.

D.

Participating in care plan meetings.

____ 9. A patient who is diagnosed with narcissistic personality disorder is constantly using the call light or following the nursing staff into other patients rooms to ask, Are you sure I look good? You know they cant get along without me at work. When can I leave here? As the nurse caring for this patient, one of your goals for the patient will include all of the following except:

A.

The patient will express reality about self-image.

B.

The patient will require decreasing reinforcements from the nursing staff.

C.

The patient will acknowledge the feelings of others.

D.

The patient will not be introspective about his or her condition.

____ 10. People who have borderline personality disorders:

A.

Do not learn from past experiences

B.

Know the consequences of their behavior but do not care.

C.

Learn from past experiences and put that knowledge into practice.

D.

Try to forget about past experiences.

____ 11. Nancy has antisocial personality disorder. Which of the following is a goal of treatment for Nancy?

A.

Comply with her medication regimen

B.

Participate in long-term therapy

C.

Become a group facilitator

D.

Eliminate her anxiety

____ 12. Tony is a 25-year-old male patient who is being treated at your hospital day-treatment center. Tony is very charming and seems popular. He has the ability to draw crowds around him, but you know he has been in trouble with the law several times since adolescence and lies constantly. You realize that Tonys behavior is most likely which personality disorder?

A.

Paranoid personality disorder

B.

Schizoid personality disorder

C.

Dependent personality disorder

D.

Antisocial personality disorder

____ 13. Schizotypal personality disorder may be confused with what other psychiatric disorder?

A.

Bipolar

B.

Schizophrenia

C.

Dual diagnosis

D.

Paranoid personality

____ 14. Which characteristic is unlikely to be present in a patient with avoidant personality?

A.

Low self-esteem

B.

Lack of pleasure in life

C.

Avoidance of social situations

D.

Very close relationships with family

____ 15. You know your patient has a personality disorder. He tells you, You are the best nurse. I am so glad you are here today and not that mean nurse who was here yesterday. Which personality disorder would be most associated with this statement?

A.

Paranoid

B.

Antisocial

C.

Passive aggressive

D.

Borderline

____ 16. Personality disorders are organized into three clusters. Which cluster is the diagnosis of schizotypal disorder placed in?

A.

Cluster A

B.

Cluster 1

C.

Cluster B

D.

Cluster C

____ 17. Your male patient tells you that he has women throwing themselves at him everywhere he goes. From this statement, what is the most likely personality disorder he is exhibiting?

A.

Borderline

B.

Narcissistic

C.

Paranoid

D.

Antisocial

____ 18. Your male patient tells you that he has women throwing themselves at him everywhere he goes. The best nursing response to the patient is:

A.

Wow, that is impressive. Give me some tips.

B.

Tell me about a recent relationship.

C.

Lets focus on activities for today.

D.

Lets go to the dayroom and see what happens.

____ 19. Which of the following statements best describes schizotypal personality disorder?

A.

A pervasive pattern of social and interpersonal deficits with reduced capacity for close relationships

B.

Disregard and violation of the rights of others

C.

A pattern of preoccupation with orderliness and perfectionism

D.

Pervasive submissive and clinging behavior

____ 20. You find your patient with antisocial personality disorder smoking in the lounge. Which response is best?

A.

Make a general overhead announcement about no smoking.

B.

Bring up the smoking issue at the next group session.

C.

Tell the patient directly he is not to be smoking here.

D.

Encourage the patient to identify why he has the need to smoke now.

____ 21. Theodore, a 45-year-old male, is admitted to a mental health unit displaying inappropriate behavior. The patient has been responding to voices when no one is in the room and isolating himself in his room. Which of the following best describes this patient?

A.

Phobia

B.

Neurosis

C.

Effective coping

D.

Psychosis

Chapter 14: Personality Disorders

Answer Section

MULTIPLE CHOICE

1. ANS: A

Antisocial personality disorder is a pattern of irresponsible, exploitive, and guiltless behavior with tendency to fail to conform to the law and exploit and manipulate others for personal gain.

PTS: 1 REF: Chapter 14: Personality Disorders; Antisocial Personality; page 219

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

2. ANS: A

Borderline personality disorder is associated with intense and chaotic relationships as well as self-destructive, impulsive, and dramatic coping.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality Disorder; page 220

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

3. ANS: D

This response clarifies the inappropriateness of the patients request and sets clear limits.

PTS: 1

REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

4. ANS: C

This response demonstrates understanding of the dynamics behind the behavior.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality; page 220

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

5. ANS: D

This response promotes the patient taking responsibility to follow through on her feelings. Response A takes the responsibility away from the patient. Response B ignores the patients feelings. Response C is less effective with a borderline patient who may not understand her feelings.

PTS: 1

REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

6. ANS: B

Though these other mechanisms may be used, manipulation is the major one.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 217

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

7. ANS: C

Dysfunctional family relationships are generally the major cause of personality disorders, though genetics plays a role in some.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 218

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

8. ANS: B

Those with personality disorders generally have the most problems in the social sphere.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 218

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

9. ANS: D

The narcissistic patient has difficulty with introspection and insight into his or her behavior.

PTS: 1 REF: Chapter 14: Personality Disorders; Narcissistic Personality; page 221-222

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

10. ANS: A

Generally, the borderline patient does not have insight into the consequences of behavior and tends to repeat the same behaviors over and over even if not successful.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality; page 220

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

11. ANS: B

Treatment is geared toward working with the client to gain insight into her behavior, which can be done with long-term therapy. Medications are generally not useful and this patient will probably not be experiencing anxiety and should not be a group leader due to being a poor influence on others.

PTS: 1

REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

12. ANS: D

People with antisocial personality disorder are usually gregarious, intelligent, and likable, but they often use manipulation to achieve their goals.

PTS: 1 REF: Chapter 14: Personality Disorders; Antisocial Personality; page 219

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

13. ANS: B

Behavior in this disorder is often odd and eccentric, but not to the level of schizophrenia.

PTS: 1 REF: Chapter 14: Personality Disorders; Schizotypal Personality Disorder; page 219

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts

14. ANS: D

Those with avoidant personality disorder have distant relationships with family.

PTS: 1 REF: Chapter 14: Personality Disorders; Avoidant Personality Disorder; page 222

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

15. ANS: D

A common characteristic of borderline personality is to see people as all good and all bad and attempt to pit one against the other to split the staff.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality; page 220

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

16. ANS: A

Schizotypal is in the cluster with paranoid and schizoid personality.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 218

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

17. ANS: B

Narcissistic personality is associated with a constant need for attention, exaggerated sense of self-importance, and fantasies of ongoing success.

PTS: 1 REF: Chapter 14: Personality Disorders; Narcissistic Personality; page 221-222

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

18. ANS: B

Encouraging the patient to focus on a specific relationship to gain some insight rather than focusing on generalizations is more helpful for the patient. Encouraging the patient or testing this belief is not therapeutic.

PTS: 1

REF: Chapter 14: Personality Disorders; Table 14-1, Nursing Interventions for Personality Disorders; page 224

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

19. ANS: A

Schizotypal personality disorders major characteristic is deficits in maintaining social relationships of any kind. Response B is a description of antisocial personality. Response C is obsessive-compulsive disorder. Response D is dependent personality.

PTS: 1 REF: Chapter 14: Personality Disorders; Schizotypal Disorder; page 219

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

20. ANS: C

This patient needs clear limits at the time of the infraction and it should be handled directly. Reponses A and B are indirect. Focusing on insight into why he smokes is not effective for patients with this disorder.

PTS: 1

REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

21. ANS: D

Psychosis is a mental state in which there is a severe loss of contact with reality.

PTS: 1 REF: Chapter 14: Personality Disorders; page 219

KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental Health Concepts

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