Personality and Mood Disorders Q 32
Which of the following nursing interventions has priority for a client with borderline personality disorder?
A. Maintain consistent and realistic limits.
B. Give instructions for meeting basic self-care needs.
C. Engage in daytime activities to stimulate wakefulness.
D. Have the client attend group therapy on a daily basis.
Correct Answer: A. Maintain consistent and realistic limits.
Clients with borderline who are needy, dependent, and manipulative will benefit greatly from maintaining consistent and realistic limits. Regardless of the clinical setting, the nurse must provide structure and limit setting in the therapeutic relationship; in a clinic setting, this may mean seeing the client for scheduled appointments of a predetermined length rather than whenever the client appears and demands the nurse’s immediate attention.
Option B: They don’t tend to have difficulty meeting their self-care needs. The nurse can help the clients to identify their feelings and learn to tolerate them without exaggerated responses such as destruction of property or self-harm; keeping a journal often helps clients gain awareness of feelings.
Option C: They don’t tend to have sleeping difficulties. Minimizing unstructured time by planning activities can help clients to manage time alone; clients can make a written schedule that includes appointments, shopping, reading the paper, and going for a walk.
Option D: They enjoy attending group therapy because they often attempt to use the opportunity to become the center of attention. It is important to teach basic communication skills such as eye contact, active listening, taking turns talking, validating the meaning of another’s communication, and using “I” statements.