A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend, who breaks off their relationship. Although she has not self-injured in over 2 months, she makes repeated lacerations on her forearm. Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?

Correct Answer: B

Rationale: The correct answer is B: However dysfunctional, most behavior is the person's best effort to cope. Rationale: 1. People with borderline personality disorder often struggle with intense emotions and unstable relationships. 2. Self-injury is a maladaptive coping mechanism used to manage overwhelming emotions or distress. 3. In this scenario, the patient resorts to self-injury as a coping strategy after the breakup triggers intense emotional pain. 4. Despite being maladaptive, the behavior serves as a coping mechanism to regulate emotions. 5. Understanding that maladaptive behaviors are often the individual's best attempt to cope helps in providing non-judgmental support and promoting healthier coping strategies. Summary: A: Incorrect. People with personality disorders can make progress with appropriate treatment and support. C: Incorrect. While external factors may trigger behaviors, individuals with personality disorders have agency in their actions. D: Incorrect. Improvement in behavior should not always be viewed as manipulation; it can indicate genuine progress in coping skills.

Correct Answer: C

Rationale: Rationale: Choice C indicates a need for further education because it suggests the patient believes they can manage bulimia without help. Patients with bulimia often require professional intervention for successful treatment. Choices A, B, and D acknowledge the need for therapy, understanding of long-term consequences, and recognition of unhealthy behaviors, respectively.

Correct Answer: B

Rationale: The correct answer is B: To help the patient eliminate purging behaviors and develop healthy eating habits. This goal is important because it addresses the core issues of bulimia nervosa, which are unhealthy purging behaviors and distorted eating patterns. By helping the patient stop purging and establish healthy eating habits, the nurse can promote long-term recovery and overall well-being. Choice A is incorrect because promoting weight loss through strict dietary control can exacerbate the patient's unhealthy relationship with food and body image. Choice C is incorrect as encouraging excessive exercise can contribute to a cycle of compulsive behaviors and worsen the patient's physical and mental health. Choice D is incorrect because focusing solely on body image issues neglects the underlying psychological factors contributing to bulimia nervosa.

Correct Answer: B

Rationale: The correct answer is B because restoring nutritional balance through safe weight gain is a realistic and appropriate goal for a nurse working with a patient with anorexia nervosa. This goal focuses on the patient's physical health and addresses the underlying issue of malnutrition. Rapid weight gain (A) may be dangerous and unsustainable. Accepting body image without intervention (C) ignores the severity of the disorder. Maintaining a healthy weight without professional assistance (D) is unlikely for someone with anorexia nervosa who requires specialized care.

Correct Answer: C

Rationale: The correct answer is C: Body image disturbance and self-imposed starvation. This is a priority because it directly addresses the core issues of anorexia nervosa and poses immediate risks to the patient's health. Body image disturbance contributes to the patient's self-imposed starvation, which can lead to severe malnutrition and other serious complications. Addressing this issue is crucial for the patient's well-being. A: Weight loss of 2 pounds over the past week is concerning but may not be an immediate priority compared to addressing the underlying psychological issues. B: Denial of the need for nutrition rehabilitation is important to address but may not pose an immediate threat to the patient's health compared to self-imposed starvation. D: Refusal to participate in social activities may be a consequence of anorexia nervosa but does not directly address the urgent need to address body image disturbance and self-imposed starvation.