A client with a borderline personality disorder tells the nurse, 'My doctor tells me there's something wrong with the hard wiring of my brain, and that's why I'm so impulsive and get so many mood swings. He said he's going to prescribe some medication.' Being aware of current practice guidelines, the nurse will prepare a teaching plan for:

Correct Answer: B

Rationale: The correct answer is B: Fluoxetine. In the context of borderline personality disorder, fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is often used to manage symptoms such as mood swings and impulsivity. SSRIs help regulate serotonin levels in the brain, which can improve mood stability and reduce impulsive behaviors. - A: Lithium is typically used for bipolar disorder, not borderline personality disorder. - C: Lorazepam is a benzodiazepine used for anxiety or panic disorders, not specific to treating symptoms of borderline personality disorder. - D: Haloperidol is an antipsychotic medication used for psychosis, not typically indicated for managing impulsivity or mood swings in borderline personality disorder.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Borderline personality disorder is characterized by fear of abandonment. 2. Self-mutilation can be a maladaptive coping mechanism to alleviate this fear. 3. The behavior is often triggered by perceived threats to relationships or autonomy. 4. Therefore, considering fear of abandonment in future planning is crucial. Summary of other choices: A: Inherited disorder is not the primary reason for self-mutilation in borderline personality disorder. C: Projective identification and splitting are defense mechanisms, not primary reasons for self-mutilation. D: Constitutional inability to regulate affect may contribute, but fear of abandonment is more central in borderline personality disorder.

Correct Answer: A

Rationale: The correct answer is A because during the refeeding phase of anorexia nervosa, monitoring weight gain and providing a structured meal plan are crucial to prevent refeeding syndrome and ensure a safe and gradual increase in caloric intake. This approach helps prevent complications such as electrolyte imbalances and organ dysfunction. Encouraging the patient to eat independently without supervision (B) can be harmful as they may not consume adequate or balanced nutrition. Psychological therapy (C) is important but not the most crucial during the refeeding phase. Offering high-calorie, high-fat foods (D) can lead to rapid weight gain and further complications.

Correct Answer: B

Rationale: The most appropriate goal for a nurse caring for a patient with anorexia nervosa is for the patient to stabilize their weight and maintain adequate nutrition (Choice B). This goal is crucial because rapid weight gain can have negative physical and psychological consequences for the patient. Stabilizing weight helps prevent complications like refeeding syndrome and supports the patient's overall health. It also addresses the immediate nutritional needs of the patient. Choices A, C, and D are incorrect because rapid weight gain can be harmful, full recovery often requires ongoing support, and body image acceptance may not be the most pressing concern for someone with anorexia nervosa.

Correct Answer: B

Rationale: The correct answer is B because monitoring electrolytes closely during refeeding is crucial to prevent life-threatening complications such as electrolyte imbalances. Refeeding syndrome can lead to shifts in electrolytes, particularly phosphorus, potassium, and magnesium, which may result in cardiac arrhythmias, respiratory failure, or even death. Close monitoring allows for timely interventions to maintain electrolyte balance. Choice A is incorrect because refeeding a patient with high-calorie foods immediately can actually exacerbate refeeding syndrome by overwhelming the body's metabolic and electrolyte regulation processes. Choice C is incorrect because allowing the patient to eat whatever they want without restrictions can lead to rapid and uncontrolled weight gain, which may worsen medical complications. Choice D is incorrect because restricting fluid intake can also contribute to electrolyte imbalances and dehydration during refeeding.