A client with borderline personality disorder lacerated her ...

[leo leo]

A client with borderline personality disorder lacerated her wrists while out on a pass. For future
  planning, staff should consider that the reason for the self-mutilation is probably related to
 
  a. an inherited disorder that manifests itself as an incapacity to tolerate stress.
  b. fear of abandonment associated with movement toward autonomy and
  independence.
  c. use of projective identification and splitting to bring anxiety to manageable levels.
  d. a constitutional inability to regulate affect, predisposing to psychic
  disorganization.

Question 2

A client with bipolar disorder who became hyperactive after discontinuing lithium has not eaten or
  slept for 3 days. Mood and behavior are labile, changing rapidly from playful to aggressive.
 
  If the
  client threatens to hit another client or a staff member, which response would constitute an
  appropriate intervention?
  a. Stop that No one did anything to provoke an attack by you..
  b. If you try that one more time, you will be placed in seclusion immediately..
  c. Do not hit me/him/her. If you are unable to control yourself, we will help you..
  d. You know we will not let you hit anyone Why do you continue such
  self-defeating behavior?

[pocatato]

Answer to Question 1

B
Fear of abandonment is a central theme for most clients with borderline personality disorder. This
fear is often exacerbated when borderline clients experience success or growth. Options A and D are
not evidence based. Option C is unrelated to fear of abandonment.

Answer to Question 2

C
When the client is unable to control his or her behavior and violates or threatens to violate the rights
of others, limits must be set in an effort to deescalate the situation. Limits should be set in simple,
concrete terms. Option A does not offer appropriate assistance to the client. Option B threatens the
client with seclusion as punishment. Option D asks a rhetorical question.