A client with borderline personality disorder tells a nurse, I'm ...

[audragclark]

A client with borderline personality disorder tells a nurse, I'm afraid to get on a train because we'll probably get into a wreck. Which response by the nurse would be most appropriate?
 
  A) Have you had a bad experience riding a train?
  B) What are the chances of that actually happening?
  C) Now, you know that won't happen.
  D) Have you thought about going by automobile?

Question 2

A nurse has explained some of the biologic theories of causation to a client diagnosed with borderline personality disorder and his family. The nurse determines that the client and family have understood the instructions when they state which of the follo
 
  A) The disorder may be caused by increased serotonin activity.
  B) The disorder is caused by decreased dopamine activity in my brain.
  C) A frontal lobe dysfunction may be causing this condition.
  D) A decrease in hormonal substances increases the risk for this illness.

[carojassy25]

Answer to Question 1

Ans: B
The nurse should challenge the client's dysfunctional thinking by encouraging the client to think about the event or situation in a different way, providing the client with a different perspective to consider. Although asking about a previous bad experience may help shed some light on the situation, the client with borderline personality disorder has dysfunctional thinking, and this needs to be addressed. Telling the client that he or she knows it won't happen or suggesting the client travel by car does not address the client's underlying pattern of thinking.

Answer to Question 2

Ans: C
Associated brain dysfunction occurs in the limbic system or frontal lobe and increases impulsive behaviors, parasuicidal behaviors, and mood disturbances. Neurotransmitters such as serotonin and dopamine, as well as hormones, have not been implicated in the cause.