Author Question: A client with borderline personality disorder has been hospitalized several times after ... (Read 44 times)

CQXA · **on:** Jul 19, 2018

A client with borderline personality disorder has been hospitalized several times after self-mutilating
episodes and suicide attempts. The client has entered dialectical behavior therapy on an outpatient
basis.

During therapy, the advanced practice nurse has been counseling her regarding self-harm
behavior management. Today the client called the nurse and reported that she is feeling empty and
anxious and wants to cut her arms. The nurse should
a. arrange for emergency in-patient hospitalization.
b. send her to the crisis intervention unit for 8 to 12 hours.
c. assist the client to identify the trigger situation and choose a coping strategy.
d. advise the client to take an anxiolytic to decrease anxiety level and go to sleep.

Question 2

Lithium citrate 600 mg 3 times daily po is ordered for a client with acute mania who is being treated
as an outpatient. The client calls the mental health nurse, stating he is nauseated.

To lessen the
nausea, the nurse can suggest that the lithium can be taken with
a. meals.
b. an antacid.
c. an antiemetic.
d. a large glass of juice.

strudel15 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

C
The client has responded appropriately to the urge to harm herself by calling a helping individual. A
component of dialectical behavior therapy is telephone access to the therapist for coaching during
crises. The nurse can assist the client to choose an alternative to self-mutilation. Options A and B:
The need for a protective environment may not be necessary if the client is able to use cognitive
strategies to determine a coping strategy that will reduce the urge to mutilate. Option D: Taking a
sedative and going to sleep should not be the first-line intervention because sedation may reduce the
client's ability to weigh alternatives to mutilating behavior.

Answer to Question 2

A
Some clients find taking lithium with meals diminishes nausea. The other options are less helpful.