What is the most challenging nursing intervention with patients ...

[futuristic]

What is the most challenging nursing intervention with patients diagnosed with personality disorders who use manipulation?
 
  a. Supporting behavioral change
  b. Maintaining consistent limits
  c. Monitoring suicide attempts
  d. Using aversive therapy

Question 2

When a patient diagnosed with a personality disorder uses manipulation to get needs met, the staff applies limit-setting interventions. What is the correct rationale for this action?
 
  a. It provides an outlet for feelings of anger and frustration.
  b. It respects the patient's wishes, so assertiveness will develop.
  c. External controls are necessary due to failure of internal control.
  d. Anxiety is reduced when staff assumes responsibility for the patient's behavior.

[Mholman93]

Answer to Question 1

ANS: B
Maintaining consistent limits is by far the most difficult intervention because of the patient's superior skills at manipulation. Supporting behavioral change and monitoring patient safety are less difficult tasks. Aversive therapy would probably not be part of the care plan because positive reinforcement strategies for acceptable behavior seem to be more effective than aversive techniques. See relationship to audience response question.

Answer to Question 2

ANS: C
A lack of internal controls leads to manipulative behaviors such as lying, cheating, conning, and flattering. To protect the rights of others, external controls must be consistently maintained until the patient is able to behave appropriately.