Which measure is advisable to take, considering that individuals with dramatic erratic personality disorders often have the ability to evade limits and manipulate others?

Correct Answer: A

Rationale: The correct answer is A: Plan frequent client-centered staff meetings. This measure is advisable as it promotes open communication, collaboration, and consistency in care. By holding regular meetings, staff can discuss concerns, share observations, and develop strategies to effectively manage individuals with erratic personality disorders. This approach helps in setting clear boundaries, identifying manipulative behaviors, and ensuring a unified team response. Summary: - Choice B: Practice take-down and restraint procedures is incorrect as it focuses on physical control rather than preventive strategies. - Choice C: Institute written or taped change-of-shift reports is incorrect as it lacks real-time communication and immediate response to potential issues. - Choice D: Rotate staff assignments so no one is responsible for the client for a prolonged period of days is incorrect as it may disrupt continuity of care and hinder the establishment of trust and rapport.

Correct Answer: B

Rationale: The correct answer is B: provide care in a matter-of-fact manner. This approach is important in treating patients with borderline personality disorder as it helps maintain boundaries and consistency, which are crucial for managing their condition. By being matter-of-fact, the nurse can prevent potential manipulation or reinforcement of maladaptive behaviors. Encouraging the patient to vent anger (choice A) may escalate the situation. Being overly sympathetic (choice C) can blur professional boundaries. Offering to listen to feelings (choice D) may reinforce the behavior and not address the underlying issues effectively.

Correct Answer: A

Rationale: The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being. Summary: - Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration. - Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation. - Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.

Correct Answer: B

Rationale: The correct answer is B. Monitoring the patient's heart rate and electrolyte levels closely is crucial in managing electrolyte imbalances in patients with bulimia nervosa. Electrolyte imbalances, often caused by purging behaviors, can lead to serious complications like cardiac arrhythmias. Close monitoring allows for timely interventions such as electrolyte replacement therapy to prevent cardiac issues. A: Encouraging the patient to drink fluids and increase food intake is not the priority when dealing with electrolyte imbalances as it may worsen the imbalance. C: Providing high-protein foods may be beneficial for overall nutrition but does not address the immediate need to correct electrolyte imbalances. D: Instructing the patient to avoid physical exercise is not directly related to managing electrolyte imbalances and may not address the underlying issue effectively.

Correct Answer: B

Rationale: The correct answer is B because promoting gradual weight gain and nutritional rehabilitation is essential in treating anorexia nervosa. Rapid weight gain can lead to medical complications and mental distress. Providing a low-calorie diet (C) contradicts the goal of weight gain. Focusing on weight maintenance without discussing food intake (D) neglects the importance of nutrition in recovery.