Schizophrenia Q 50
A client with borderline personality disorder becomes angry when he is told that today’s psychotherapy session with the nurse will be delayed 30 minutes because of an emergency. When the session finally begins, the client expresses anger. Which response by the nurse would be most helpful in dealing with the client’s anger?
A. “If it had been your emergency, I would have made the other client wait.”
B. “I know it’s frustrating to wait. I’m sorry this happened.”
C. “You had to wait. Can we talk about how this is making you feel right now?”
D. “I really care about you and I’ll never let this happen again.”
Correct Answer: C. “You had to wait. Can we talk about how this is making you feel right now?”
This response may diffuse the client’s anger by helping to maintain a therapeutic relationship and addressing the client’s feelings. 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 A: This wouldn’t address the client’s anger. Cognitive restructuring is a technique useful in changing patterns of thinking by helping clients to recognize negative thoughts and feelings and to replace them with positive patterns of thinking; thought stopping is a technique to alter the process of negative or self-critical thought patterns.
Option B: This is incorrect because the client with a borderline personality disorder blames others for things that happen, so apologizing reinforces the client’s misconceptions. Establish boundaries in relationships. 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 D: The nurse can’t promise that a delay will never occur again because such matters are outside the nurse’s control. Help clients to cope and to control emotions. 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.