Josie, a 27-year-old patient, complains that most of the staff do not like her. She says she can tell that you are a caring person. Josie is unsure of what she wants to do with her life and her 'mixed-up feelings' about relationships. When you tell her that you will be on vacation next week, she becomes very angry. Two hours later, she is found using a curling iron to burn her underarms and explains that it 'makes the numbness stop.' Given this presentation, which personality disorder would you suspect?

Correct Answer: B

Rationale: The correct answer is B: Borderline Personality Disorder. Josie's intense fear of abandonment, unstable self-image, impulsivity, and self-harming behavior are classic symptoms of borderline personality disorder. Her sudden anger when you mention your vacation and her self-harming behavior to cope with emotional distress are indicative of this disorder. A: Obsessive-compulsive personality disorder is characterized by a preoccupation with orderliness and control, not by self-harm or intense emotional instability like Josie's case. C: Antisocial personality disorder involves a disregard for others' rights and feelings, which does not align with Josie's fear of abandonment and self-harm behavior. D: Schizotypal personality disorder features odd beliefs and behaviors, social isolation, and paranoia, not the impulsive, self-destructive behavior seen in Josie.

Correct Answer: D

Rationale: Visceral pain refers to pain originating from internal organs. It has a slower onset, is diffuse, and often radiates. Somatic pain refers to pain originating from the skin, muscles, or bones, not internal organs. Acute pain is sudden and short-lived, not slow onset. Chronic pain is persistent and long-lasting, not necessarily marked by somatic pain from internal organs. Superficial pain is pain originating from the surface of the body, not internal organs. Therefore, the correct answer is D (visceral pain) as it aligns with the characteristics described in the question.

Correct Answer: A

Rationale: The correct answer is A because psychiatric-mental health nursing practice involves assessing clients, providing education, administering medications, and screening for suicide risk. Assessment helps in understanding the client's mental health status. Education empowers clients to manage their condition. Medication administration ensures proper treatment. Suicide risk screening is crucial for client safety. Choices B, C, and D are incorrect as they include tasks outside the scope of psychiatric-mental health nursing such as medical diagnosis, giving orders, assisting with ADLs, and giving advice.

Correct Answer: A

Rationale: The correct answer is A because consistency in adhering to unit guidelines provides a structured environment that can help a client experiencing concrete thinking feel safe and secure. It establishes predictability, which is crucial for building trust. Calling the client by name (B) is a common courtesy but may not directly address the client's concrete thinking. Sharing what the client is feeling (C) may not be effective as the client may have difficulty understanding or processing emotions. Teaching the meaning of idioms (D) is irrelevant to establishing trust with a client experiencing concrete thinking.

Correct Answer: A

Rationale: The correct answer is A because a nurse with a background in medical/surgical care would likely have experience managing chronically depressed clients, who may require a more general medical approach. Choices B, C, and D involve more specialized psychiatric care, such as managing active psychosis, paranoid thinking, or personality disorders, which may require specific psychiatric training and interventions beyond the nurse's medical/surgical expertise. Therefore, assigning a nurse to care for a chronically depressed client aligns with their skill set and minimizes the risk of inadequate care or potential harm to clients with more acute psychiatric needs.