When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?

Correct Answer: D

Rationale: The correct answer is D, developing a safety plan with the patient. This intervention is crucial for addressing self-harm behaviors in patients with borderline personality disorder. A safety plan helps the patient identify triggers, warning signs, coping strategies, and support networks to prevent self-harm. It also outlines specific steps to take in a crisis situation. This intervention is more direct and practical compared to the other options. A: Keeping a journal may be helpful for self-reflection but may not provide immediate strategies to prevent self-harm. B: Setting boundaries is important but may not directly address self-harm behaviors. C: Providing coping skills is beneficial, but a safety plan is more specific and tailored to managing self-harm risks. In summary, developing a safety plan is the most effective intervention for addressing self-harm behaviors in patients with borderline personality disorder.

Correct Answer: A

Rationale: The correct answer is A: Decreased need for sleep. During a manic episode in bipolar disorder, individuals often experience decreased need for sleep. This is a key symptom of mania, as it is characterized by high energy levels, impulsivity, and decreased need for rest. In contrast, option B (feelings of worthlessness) is more reflective of symptoms seen in depressive episodes, not manic episodes. Option C (increased need for sleep) is also not indicative of mania, as mania is associated with decreased sleep. Option D (avoidance of social interactions) may occur in some cases, but it is not a defining feature of mania.

Correct Answer: D

Rationale: The correct answer is D: Nausea. Sertraline, a selective serotonin reuptake inhibitor (SSRI), commonly causes gastrointestinal side effects like nausea. This occurs due to increased serotonin levels affecting the digestive system. Dry mouth (A) is more common with other medications like anticholinergics. Weight gain (B) is a potential side effect of some antidepressants but not typically with sertraline. Insomnia (C) can occur with SSRIs, but it is less common than nausea as an initial side effect. Monitoring for nausea is essential to ensure the patient's adherence to treatment and well-being.

Correct Answer: B

Rationale: The correct answer is B: Thought stopping. In CBT, thought stopping is a technique used to interrupt and replace negative or intrusive thoughts. Here's why it's correct: 1. It helps clients identify and challenge negative thought patterns. 2. It teaches clients to stop negative thoughts in their tracks. 3. It encourages the use of positive affirmations or coping statements. Other choices are incorrect: A: Free association is a psychoanalytic technique, not a CBT technique. C: Dream analysis is also associated with psychoanalytic therapy. D: Systematic desensitization is a behavioral therapy technique used in exposure therapy, not CBT.

Correct Answer: D

Rationale: The correct answer is D: Providing the patient with a structured daily routine. This intervention is most appropriate as it helps the patient establish a sense of stability, predictability, and purpose in their daily life, which can be beneficial in managing depressive symptoms. By having a routine, the patient can develop a sense of accomplishment and control, improve sleep patterns, and reduce feelings of hopelessness and helplessness. Encouraging the patient to express their feelings through art (A) may be helpful as a supplementary intervention, but it may not provide the necessary structure and consistency needed for coping skills development. Providing information about the diagnosis (B) is important but may not directly address coping skills. Keeping a journal of thoughts and feelings (C) can be beneficial, but a structured routine provides more tangible support for developing coping skills.