A nurse is caring for a group of clients within the DSM-5 Cluster ...

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A nurse is caring for a group of clients within the DSM-5 Cluster B category of personality disorders. Which factors should the nurse consider when planning client care? Select all that apply.
 
  A. These clients have personality traits that are deeply ingrained and difficult to modify.
  B. These clients need medications to treat the underlying physiological pathology.
  C. These clients use manipulation, making the implementation of treatment problematic.
  D. These clients have poor impulse control that hinders compliance with a plan of care.
  E. These clients commonly have secondary diagnoses of substance abuse and depression.

Question 2

Which statements represent positive outcomes for clients diagnosed with narcissistic personality disorder? Select all that apply.
 
  A. The client will relate one empathetic statement toward another client in group, by day 2.
  B. The client will identify one personal limitation by day 1.
  C. The client will acknowledge one strength that another client possesses by day 2.
  D. The client will list four personal strengths by day 3.
  E. The client will list two lifetime achievements by discharge.

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Answer to Question 1

ANS: A, C, D, E
The nurse should consider that individuals diagnosed with cluster Btype personality disorders have deeply ingrained personality traits, use manipulation, have poor impulse control, and often have secondary diagnoses of substance abuse and/or depression. This cluster includes antisocial, borderline, histrionic, and narcissistic personality disorders.

Answer to Question 2

ANS: A, B, C
The nurse should determine that appropriate outcomes for a client diagnosed with narcissistic personality disorder include relating empathetic statements to other clients, identifying one personal limitation, and acknowledging one strength in another client. An exaggerated sense of self-worth, a lack of empathy, and exploitation of others are characteristics of narcissistic personality disorder.

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