.png){kind=logo}
1. A nurse is planning care for a client who has borderline personality disorder
who self-mutilates. Which of the following test approaches should the nurse plan
to take?
a. Restrict participation in group therapy sessions.
The nurse should encourage the client who has borderline personality
disorder to participate in group therapy sessions to encourage appropriate
interaction with other clients.
b. Establish consequences for self-mutilation.
The nurse should respond to self-mutilation with a neutral affect and
encourage the client to write down feelings that occurred leading up to the
incident.
c. Maintain close observation of the client.
Clients who have borderline personality disorder are at risk for selfharm during times of increased anxiety. Maintaining close observation
reduces the client's risk of injury.
d. Provide an unstructured environment.
Providing an unstructured environment for a client who has borderline
personality disorder is not an effective treatment approach because it does
not provide a safe environment to protect the client from impulsive and
self-injurious behavior.
2. A nurse is assessing a client who has Stage 4 Alzheimer's disease. Which of the
following findings should the nurse expect?
a. The client requires assistance with eating.
The nurse should expect the client who has Stage 4 Alzheimer’s disease to
still have the ability to eat without assistance. Clients who have Alzheimer’s
disease maintain this ability until Stage 7.
b. The client independently manages personal finances.
The nurse should expect the client who has Stage 4 Alzheimer’s disease to
have difficulty performing complex tasks, such as managing personal
finances.
c. The client has bladder incontinence.
The nurse should expect the client who has Stage 4 Alzheimer’s disease to
be able to use the toilet independently. Clients who have Alzheimer’s
.png)