A client admitted with borderline personality disorder complains ...

[leo leo]

A client admitted with borderline personality disorder complains during group therapy that she, always falls for the bad guy. She has been in and out of rehabilitation and abuse crisis centers.
 
  The nursing student knows this client would benefit from: 1. Intrapsychic cognitive therapy.
  2. Family conflict therapy.
  3. Dialectical behavioral therapy.
  4. Self-reflective therapy.

Question 2

A client comes to the nurse's station yelling, I have to call the FBI. The bombs are set to destroy Washington, D.C. at 1:00 p.m. Please help me. It will be your fault if I don't call.
 
   Which intervention best demonstrates the nurse's sensitivity? 1. Assist the client to become aware that this is a delusional belief.
  2. Listen carefully for the underlying emotion expressed by the client's request.
  3. Share your concerns that the client's request is unreasonable.
  4. Switch the topic of conversation to defuse the client's underlying agitation.

[zoeyesther]

Answer to Question 1

3
Rationale: Linehan specifically developed dialectical behavioral therapy (DBT) for the outpatient treatment of chronically suicidal people with borderline personality disorder. DBT is a specialized subset of the cognitive behavioral treatment modalities. The client with borderline personality disorder tends to be crisis prone, with intense relational episodes. In other words, interactions with others have the potential to disrupt the client powerfully.

Answer to Question 2

2
Rationale: Listening for the tone underlying the client's request, rather than responding to the actual request, demonstrates the nurse's sincerity and non-defensive approach to the client. Switching topics breaks down communication. Believing the client's request is unreasonable or identifying the belief as delusional invalidates the client's feelings and reflects insensitivity to the client's concern.