A patient diagnosed with borderline personality disorder has ...

[imanialler]

A patient diagnosed with borderline personality disorder has self-inflicted wrist lacerations. The health care provider prescribes daily dressing changes. The nurse performing this care should:
 
  a. maintain a stern and authoritarian affect.
  b. provide care in a matter-of-fact manner.
  c. encourage the patient to express anger.
  d. be very rigid and challenging.

Question 2

A nurse set limits while interacting with a patient demonstrating behaviors associated with borderline personality disorder. The patient tells the nurse, You used to care about me. I thought you were wonderful. Now I can see I was wrong.
 
  You're evil. This outburst can be assessed as:
 
  a. denial.
  b. splitting.
  c. defensive.
  d. reaction formation.

[scikid]

Answer to Question 1

ANS: B
A matter-of-fact approach does not provide the patient with positive reinforcement for self-mutilation. The goal of providing emotional consistency is supported by this approach. The distracters provide positive reinforcement of the behavior or fail to show compassion.

Answer to Question 2

ANS: B
Splitting involves loving a person, then hating the person because the patient is unable to recognize that an individual can have both positive and negative qualities. Denial is unconsciously motivated refusal to believe something. Reaction formation involves unconsciously doing the opposite of a forbidden impulse. The scenario does not indicate defensiveness. See relationship to audience response question.

[imanialler]

Thank you

[scikid]

No problemo