Personality and Mood Disorders Q 76
The plan of care for clients with borderline personality should include:
A. Limit setting and flexibility in schedule.
B. Giving medications to prevent acting out.
C. Restricting her from other clients.
D. Ensuring she adheres to certain restrictions.
Correct Answer: D. Ensuring she adheres to certain restrictions.
The client is manipulative. The client must be informed about the policies, expectations, rules, and regulations upon admission. The nurse must be quite clear about establishing the boundaries of the therapeutic relationship to ensure that neither the client’s nor the nurse’s boundaries are violated.
Option A: Limits should be firmly and consistently implemented. Flexibility and bargaining are not therapeutic in dealing with a manipulative client. 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: There is no specific medication prescribed for this condition. Medications are in no way curative for any personality disorder; they should be viewed as an adjunct to psychotherapy so that the patient may productively engage in psychotherapy.
Option C: This is not part of the care plan. Interaction with other clients are allowed, but the client should be observed and given limits in her attempt to manipulate and dominate others. 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.