A nurse is teaching the family of a client who has a new diagnosis of borderline personality disorder about the disorder. Which of the following information should be the nurse's priority?

Correct Answer: C

Rationale: In this scenario, the nurse's priority should be option C: Awareness of potential for self-harm. Borderline personality disorder is characterized by impulsivity, emotional instability, and a high risk of self-harm or suicide. By educating the family about the potential for self-harm, the nurse is addressing a critical safety concern and helping the family understand the seriousness of the diagnosis. This information empowers the family to provide a safe environment and intervene effectively in case of a crisis. Option A, providing resources for group therapy, is important for long-term management of borderline personality disorder, but safety concerns must be addressed first. Option B, medication compliance, is relevant but not as immediate as addressing the risk of self-harm. Option D, information about insurance coverage, is important but is not as urgent or critical as ensuring the safety of the client. In an educational context, understanding the priority of addressing immediate safety concerns in clients with borderline personality disorder is crucial for nurses providing care in behavioral health settings. Emphasizing the importance of assessing and managing the risk of self-harm is fundamental to ensuring the well-being of clients with this condition.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Alzheimer's disease. Cortical thinning is a characteristic feature of Alzheimer's disease, a type of dementia that primarily affects areas of the brain responsible for memory, thinking, and language. This thinning is due to the degeneration and loss of nerve cells in the cerebral cortex over time. Option A) Prion disease is characterized by the accumulation of abnormal prion proteins in the brain, leading to rapid neurological deterioration, but it does not typically present with cortical thinning as seen in Alzheimer's disease. Option C) Substance use disorder primarily affects brain function through the effects of substances on neurotransmitter systems and neural pathways, rather than cortical thinning. Option D) HIV infection can lead to neurocognitive disorders, but cortical thinning is not a typical feature of HIV-related brain changes. Educationally, understanding the specific brain changes associated with different types of dementia is crucial for nurses caring for patients with cognitive impairments. Recognizing cortical thinning as a hallmark of Alzheimer's disease can aid in early detection, appropriate care planning, and effective communication with the healthcare team and family members.

Correct Answer: D

Rationale: The correct answer is D) The fear of abandonment associated with progress toward autonomy and independence. This is the likely trigger for the self-inflicted wrist lacerations in a patient with borderline personality disorder. Individuals with this disorder often have intense fears of abandonment and struggle with feelings of insecurity and instability in relationships. As the patient gains new privileges and moves towards autonomy, the fear of being abandoned or rejected can trigger self-destructive behaviors as a way to cope with overwhelming emotions. Option A) An inherited disorder that manifests itself as an incapacity to tolerate stress, while stress intolerance can be a component of borderline personality disorder, it does not directly address the trigger of abandonment fears. Option B) The use of projective identification and splitting to bring anxiety to manageable levels refers to defense mechanisms that individuals with borderline personality disorder may use, but this does not directly explain the trigger for the self-mutilation. Option C) A constitutional inability to regulate affect, predisposing to psychic disorganization addresses a characteristic of borderline personality disorder but does not specifically link it to the trigger of fear of abandonment. Educationally, understanding the triggers for self-destructive behaviors in individuals with borderline personality disorder is crucial for nurses to provide effective care and support. By recognizing the underlying fears and insecurities, nurses can implement strategies to help patients cope with their emotions and develop healthier ways of managing distress.

Correct Answer: B

Rationale: In this case, option B, "Moving to three new homes over a 2-year period," would prompt the nurse to carefully assess the 8-year-old child for the development of a psychiatric disorder. This option indicates a significant life stressor that can impact a child's mental health. Frequent relocations can disrupt a child's sense of stability, leading to feelings of insecurity, anxiety, and difficulty in forming secure attachments. Option A, "Being raised by a parent with chronic major depressive disorder," is a risk factor for the child to develop psychiatric issues, but it does not necessarily indicate immediate need for assessment in the child. Option C, "Not being promoted to the next grade," is a common stressor for children but is not directly linked to the development of a psychiatric disorder. Option D, "Having an imaginary friend," is a normal part of child development and does not inherently suggest a psychiatric disorder. In an educational context, it is crucial for nurses to understand the impact of environmental stressors on children's mental health. By recognizing significant life events like multiple relocations, nurses can intervene early to support the child's emotional well-being and prevent the escalation of mental health issues. Understanding the nuances of childhood development and the influence of environmental factors is essential for providing holistic and effective behavioral health nursing care.

Correct Answer: C

Rationale: The priority nursing diagnosis in this scenario is C) Risk for suicide. This choice takes precedence because the patient's admission of suicidal ideations poses an immediate threat to their safety and well-being. Addressing this risk is crucial to prevent harm and ensure the patient's safety. Option A) Imbalanced nutrition: Less than body requirements is not the priority in this case, as the patient's weight loss, while concerning, is secondary to the acute risk of suicide. Option B) Chronic low self-esteem and option D) Hopelessness are important considerations in caring for a patient with major depressive disorder, but they are not as urgent as addressing the immediate risk of suicide. These nursing diagnoses can be addressed once the patient's safety is ensured. Educationally, this case underscores the critical importance of prioritizing nursing diagnoses based on the level of urgency and potential harm to the patient. Nurses must be able to quickly identify and address the most pressing issues to provide safe and effective care. In this situation, the priority is ensuring the patient's safety by addressing the risk for suicide as the primary concern.