Priority nursing interventions for a client with borderline personality disorder who has a history of self-mutilation and is currently angry, irritable, and impulsive would be:

Correct Answer: A

Rationale: The correct answer is A: Establishing a contract for safety with the client. This is the priority intervention as it focuses on ensuring the client's immediate safety. By setting up a contract for safety, the nurse can collaborate with the client on identifying warning signs and developing a plan to prevent self-harm. Choice B (Teaching the client ways to manage anger) and Choice C (Helping the client tolerate feelings) are important interventions but may not be as urgent as ensuring the client's safety in this scenario. Choice D (Implementing behavioral modification) is not the priority because the client's safety needs to be addressed first before focusing on behavioral changes.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Eliminating purging behaviors addresses the primary symptom of bulimia nervosa. 2. Establishing healthy eating habits promotes long-term recovery and overall well-being. 3. Focusing on behavior change rather than weight control aligns with evidence-based treatment. 4. This goal is client-centered, prioritizing the patient's mental and physical health. Summary: A: Focusing solely on exercise does not address the root cause of bulimia. C: Emphasizing weight maintenance may reinforce unhealthy body image and behaviors. D: Adopting a restrictive diet can exacerbate disordered eating patterns and harm health.

Correct Answer: A

Rationale: Step 1: Withholding of feelings is a key feature of avoidant personality disorder, indicating difficulty in expressing emotions. Step 2: Low self-esteem is also characteristic, as individuals with this disorder often feel inadequate and inferior. Step 3: Insistence on others conforming to own methods (B) is more indicative of narcissistic personality disorder. Step 4: Engaging in impulsive acts like unsafe sex (C) is more aligned with borderline personality disorder. Step 5: Initial charm dissolving into coldness and blaming others (D) is a trait of antisocial personality disorder.

Correct Answer: A

Rationale: The correct answer is A because it demonstrates empathy and offers a therapeutic approach to help the patient manage their hair-trigger responses. By suggesting ways to slow down and think before acting, the nurse is providing practical strategies for the patient to work on self-regulation and impulse control. This response shows active listening and a commitment to supporting the patient in developing coping mechanisms. Option B is incorrect as it focuses on exploring the root cause rather than offering immediate support. Option C is incorrect as it may encourage dwelling on past mistakes rather than focusing on problem-solving. Option D is incorrect as it praises the patient without addressing the need for behavior change.

Correct Answer: B

Rationale: The correct answer is B: Dependent. This presentation is most consistent with dependent personality disorder because the daughter is displaying excessive need for someone to take care of her and make decisions for her, as well as seeking reassurance and guidance when anxious. Individuals with dependent personality disorder often lack self-confidence and rely heavily on others for emotional and physical needs. Choice A: Histrionic personality disorder is characterized by attention-seeking behavior and excessive emotions, which do not match the daughter's presentation. Choice C: Narcissistic personality disorder involves a grandiose sense of self-importance and a lack of empathy for others, which is not evident in the daughter's behavior. Choice D: Borderline personality disorder is characterized by unstable relationships, self-image, and emotions, as well as impulsive behaviors, which are not reflected in the daughter's need for constant direction and reassurance.