Personality and Mood Disorders Q 98
Barbara is a client with a borderline personality disorder. She is defensive and emotionally labile and often becomes suddenly and explosively angry. When interacting with her, you as a nurse would:
A. Point out how angry Barbara is becoming, and confront the behavior.
B. Take a calm, quiet, and non-confrontational approach, and avoid arguing with Barbara.
C. Tell Barbara to calm down and to avoid becoming explosive or restraints will be used.
D. Use a gentle touch and a caring approach to calm Barbara.
Correct Answer: B. Take a calm, quiet, and non-confrontational approach, and avoid arguing with Barbara.
The best way to respond to the client with angry behavior is a calm, non-confrontational, non-argumentative approach. This will avoid further escalating the client’s behavior. Use a calm and firm approach. Provides structure and control for a client who is out of control.
Option A: Confronting the client’s behavior could exacerbate anger and trigger explosive behavior. Remain neutral as possible; Do not argue with the client. The client can use inconsistencies and value judgments as justification for arguing and escalating mania.
Option C: Telling the client to calm down minimizes the client’s problems, and the mention of restraints may be perceived as threatening to the client. Redirect agitation and potentially violent behaviors with physical outlets in an area of low stimulation (e.g., punching bag).
Option D: Touch may also be perceived as threatening; it is not recommended for a client who may become explosive. Maintain a consistent approach, employ consistent expectations, and provide a structured environment.