19. A nurse's priority related to clients who are experiencing clinical manifestations of borderline personality disorder should be to:
19. A nurse's priority related to clients who are experiencing clinical manifestations of borderline personality disorder should be to:
. Increase therapeutic communication when the client exhibits intrusiveness.
. Set limits when the client exhibits threats of self-damaging behaviors.
. Engage in one-to-one discussions about childhood experiences.
. Employ behavior modification using covert techniques.
Test-Taking Tip
Remember the clinical manifestations of the borderline client. These clients are very manipulative and require firm limits.
Content Area: Mental Health, Borderline Disorder; Integrated Process: Nursing Process, Planning; Cognitive Level: Application; Client Need/Subneed: Psychosocial Integrity/Mental Health Concepts
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Answer 1 is incorrect because it is important to set limits with negative behaviors rather than having therapeutic communication sessions. Answer 2 is correct because the client who is borderline may demonstrate a need for attention and break unit-based rules (e.g., hiding contraband), which could lead to behaviors that are dangerous (e.g., self-mutilation). The nurse reinforces expected behaviors through setting limits. Answer 3 is incorrect because it is not therapeutic to probe into the client's childhood experiences at this time, as it will not help to correct destructive or self-damaging behavior. Answer 4 is incorrect because it creates a lack of trust and is not therapeutic to use any covert (i.e., hidden) tactics to change the client's behavior.