The nurse is assessing a client who is diagnosed with borderline personality disorder. Which client statement indicates the client is at risk for self-injurious behavior?

Correct Answer: D

Rationale: The correct answer is D because impulsivity is a common characteristic of borderline personality disorder and can lead to self-injurious behaviors. The statement "It is almost as if as soon as I think of doing something, I immediately do it" indicates a lack of impulse control and potential for engaging in harmful behaviors without considering consequences. A: This statement expresses feelings of depression but does not directly indicate self-injurious behavior risk. B: This statement suggests a lack of autonomy but does not directly indicate self-injurious behavior risk. C: This statement describes dissociation, which is common in borderline personality disorder but does not directly indicate self-injurious behavior risk. In summary, choice D is the correct answer as it directly implies impulsivity and potential for self-injurious behavior, while the other choices do not clearly indicate this risk.

Correct Answer: C

Rationale: The correct answer is C because reassuring the patient that the environment is safe can help reduce their feelings of anxiety or fear, which may be causing the aggressive behavior. This approach focuses on creating a calming and supportive atmosphere, which is essential in managing challenging behaviors in dementia patients. A: Gently touching the patient's arm may escalate the situation and provoke a negative response. B: Asking the patient 'What do you need?' may not address the underlying cause of the behavior and could be perceived as confrontational. D: Directing the patient to cease the behavior may be seen as threatening and could lead to further aggression.

Correct Answer: D

Rationale: Step 1: Identify the conflicting viewpoints - The patient believes in the right to die, while the nurse opposes this view. Step 2: Analyze the underlying values - The patient prioritizes autonomy, while the nurse emphasizes the sanctity of life. Step 3: Evaluate the correctness of each viewpoint - Both perspectives have validity based on individual values and beliefs. Step 4: Determine the best analysis - Choice D, "Differing values are reflected in the two statements," is correct as it acknowledges the clash of values without dismissing either perspective.

Correct Answer: B

Rationale: The correct answer is B because children often express grief through physical symptoms like aches and pains. This is known as somatic complaints. Children may find it difficult to articulate their emotions verbally, so physical symptoms may manifest instead. Option A is incorrect as talking about scary novels is not a common response to grief in children. Option C is incorrect as fear of leaving home is more associated with separation anxiety. Option D is incorrect as becoming obsessed with religious rituals is not a typical response to grief in children.

Correct Answer: C

Rationale: Step 1: The correct answer is C because it indicates a prolonged period of over 2 months of persistent symptoms such as crying, inability to eat or sleep. Step 2: This prolonged duration of symptoms is indicative of a potential depressive episode. Step 3: The inability to eat or sleep are common symptoms of depression. Step 4: This statement highlights a significant change in the father's behavior following the mother's death, suggesting a possible depressive disorder. Summary: Choice A: The duration of symptoms is not as prolonged as in choice C. Choice B: While agitation and anxiety can be symptoms of depression, they are not as specific or severe as the symptoms in choice C. Choice D: The timeframe of symptoms mentioned here is not as long as in choice C, making it less concerning for depression.