The nurse has recently set limits for a patient with borderline personality disorder. The patient tells the nurse, 'You used to care about me. I thought you were wonderful. Now I can see I was mistaken. You're hateful.' Which phenomenon is represented by this response?

Correct Answer: A

Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism commonly seen in individuals with borderline personality disorder where they perceive others as either all good or all bad. In this scenario, the patient's sudden shift from viewing the nurse as wonderful to hateful demonstrates splitting. The patient is unable to integrate both positive and negative aspects of the nurse's behavior, leading to extreme and polarized perceptions. Choice B: Denial involves refusing to accept reality to protect oneself from uncomfortable truths, which is not demonstrated in this response. Choice C: Reaction formation is a defense mechanism where an individual behaves in a way that is opposite to their true feelings, which is not evident in the patient's response. Choice D: Projection involves attributing one's own unacceptable thoughts or feelings onto someone else, which is not the case in this scenario.

Correct Answer: B

Rationale: The correct answer is B because it describes the hallmark behavior of bulimia nervosa, which involves recurrent episodes of binge eating followed by compensatory behaviors such as purging or excessive exercise. This behavior pattern distinguishes bulimia from other eating disorders. Refusal to eat and excessive weight loss (A) is more indicative of anorexia nervosa. Severe caloric restriction and weight obsession (C) are more characteristic of anorexia as well. Compulsive overeating with no attempt to control intake (D) is more aligned with binge eating disorder, not bulimia nervosa.

Correct Answer: B

Rationale: The correct answer is B: Assessing for complications related to electrolyte imbalances. This is the primary concern when caring for a patient with bulimia nervosa who has been purging regularly because purging behaviors, such as self-induced vomiting or laxative abuse, can lead to severe electrolyte imbalances which can be life-threatening. Electrolyte imbalances can result in cardiac arrhythmias, muscle weakness, and other serious complications. Managing weight gain (A), encouraging exercise (C), and promoting food restriction (D) are not appropriate approaches as they can exacerbate the patient's unhealthy behaviors and may worsen their condition. It is crucial to prioritize assessing and addressing electrolyte imbalances to ensure the patient's safety and well-being.

Correct Answer: B

Rationale: The correct answer is B: Severe weight loss and dry skin. In anorexia nervosa, individuals typically experience significant weight loss due to severe restriction of food intake. This leads to a low body weight, which is a key physical sign of the disorder. Dry skin is also common in anorexia nervosa due to malnutrition. Rationale: A: Hypoglycemia and tachycardia are not specific physical signs of anorexia nervosa. While tachycardia (rapid heart rate) can occur due to the stress on the body, it is not as specific as severe weight loss. C: Increased appetite and excessive weight gain are not characteristic of anorexia nervosa, as individuals with this disorder typically have a distorted body image and fear gaining weight. D: High blood pressure and rapid heart rate are not typical physical signs of anorexia nervosa. Anorexia nervosa is more commonly associated with low blood pressure due to mal

Correct Answer: B

Rationale: The correct answer is B: Fluoxetine. Borderline personality disorder (BPD) is primarily treated with psychotherapy, but in some cases, medication is used to manage symptoms like impulsivity and mood swings. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly used to address mood instability and impulsivity in BPD. SSRIs help regulate serotonin levels in the brain, which can improve mood stability and decrease impulsive behaviors. Lithium (choice A) is used for bipolar disorder, not BPD. Lorazepam (choice C) is a benzodiazepine used for anxiety and not typically recommended for BPD. Haloperidol (choice D) is an antipsychotic used for conditions like schizophrenia and not typically indicated for BPD.