When assessing a client with borderline personality disorder ...

[james]

When assessing a client with borderline personality disorder (BPD), which of the following would a nurse expect to assess? Select all that apply.
 
  A) Freely shares feelings with others
  B) Control necessary for a relationship
  C) Fear of rejection
  D) Exaggerated sense of self
  E) Self-injurious behavior

Question 2

A nurse is preparing to assess a client with a paranoid personality trait. The nurse integrates knowledge of this condition, anticipating that the client's affect and behavior will most likely be which of the following?
 
  A) Angry and hostile
  B) Flirtatious and seductive
  C) Fearful and anxious
  D) Friendly and open

[Bigfoot1984]

Answer to Question 1

Ans: B, C, E
People with BPD have an extreme fear of abandonment as well as a history of unstable, insecure attachments. These individuals, who already are intensely emotional and have a poor sense of self, feel estranged from others and inadequate in the face of perceived social standards. Intense shame and self-hate follow. These feelings often result in self-injurious behaviors, such as wrist cutting, self-burnings, or head banging. People with BPD use elaborate strategies to structure interactions. That is, they restrict their relationships to ones in which they feel in control. They distance themselves from groups when feeling anxious (which is most of the time) and rarely use their social support system. Even if they are married or have a supportive extended family, they are reluctant to share their feelings. They do not want to burden anyone; they fear rejection and assume that people are tired of hearing them repeat the same issues.

Answer to Question 2

Ans: A
People with paranoid personality traits are unforgiving and hold grudges; their typical emotional responses are anger and hostility. They distance themselves from others and are outwardly argumentative and abrasive; internally, they feel powerless, fearful, and vulnerable. Other hallmark features of paranoid personality disorder are persistent ideas of self-importance and the tendency to be rigid and controlled. Thus, the client would not be flirtatious, seductive, fearful, anxious, friendly, or open.