A patient at the clinic describes periods of sadness and ...

[D2AR0N]

A patient at the clinic describes periods of sadness and depression as well as episodes of elation over the past 3 years
 
  The patient adds, Fortunately, I have been able to keep my job despite these mood changes. These findings are most consistent with which disorder?
  a. Bipolar I
  b. Bipolar II
  c. Cyclothymic
  d. Seasonal affective

Question 2

Which nursing intervention is most likely to result in heightened self-awareness for a patient diagnosed with a personality disorder in the dramatic-erratic cluster?
 
  a. Setting firm limits on behavior
  b. Providing clear expectations for acceptable behavior
  c. Using confrontational approaches to reduce self-mutilation
  d. Encouraging the patient to keep a daily journal to be shared with the nurse

[Dunkey]

Answer to Question 1

C
Cyclothymic disorder is characterized by mood swings between hypomania and depressive symptoms, with behavior at the poles being less severe than mania or depression. The patient's ability to remain employed indicates that the periods of elation were hypomania rather than mania. The patient's description does not meet criteria for any of the other options listed.

Answer to Question 2

D
Patients can be helped to understand themselves and their feelings by keeping a journal. Sharing the journal with the nurse fosters greater understanding and a sense of autonomy and responsibility. The other options do not heighten self-awareness.