Anamarie A.

Berania

Critical Thinking Questions

1. Where do you see yourself in relation to the four types of temperament (harm
avoidance, novelty seeking, reward dependence, and persistence)?
I see myself in harm avoidance. It is because of I always careful in everything
that Im doing because I dont want to get myself hurt.
2. There is a significant correlation between the diagnosis of antisocial personality
disorder and criminal behaviour. The DSM-IV-TR includes violation of the rights of
others in the definition of this disorder. Is this personality disorder more a social
than a mental health problem? Why?
For me, I think they are just equal for a person with personality disorder. A
person with a personality disorder thinks too much when they have problems
and depress themselves that may result of wanting themselves to be alone.
They dont want to socialize with other people and they keep their problems
with themselves only.

Anamarie A. Berania

CLINICAL EXAMPLE
Susan Marks, 25 years old, is diagnosed with borderline personality disorder. She has
been attending college sporadically but has only 15 completed credits and no real
career goal. She is angry because her parents have told her she must get a job to
support herself. Last week, she met a man in the park and fell in love with him on the
first date. She has been calling him repeatedly, but he will not return her calls. Declaring
that her parents have deserted her and her boyfriend doesnt love her anymore, she
slashes her forearms with a sharp knife. She then calls 911, stating, Im about to die!
Please help me! She is taken by ambulance to the emergency room and is admitted to
the inpatient psychiatry unit.
1. Identify two priority nursing diagnoses that would be appropriate for Susan on her
admission to the unit.
I think, Risk for Self-Mutilation and Ineffective Coping are appropriate nursing
diagnosis for Susan.
2. Write an expected outcome for each of the identified nursing diagnoses.
The expected outcome for Risk for Self-Mutilation is the client will be safe and
free of significant injury and for Ineffective Coping is the client will demonstrate
increased control of impulsive behaviour.
3. List three nursing interventions for each of the identified nursing diagnoses.
Risk for Self-Mutilation: Discuss presence and intensity of self-harm urges with
client; negotiate a no-self-harm contract with the client; help the client to identify
triggers for self-harm behavior.
Ineffective Coping: Help the client to identify feelings by keeping a journal;
discuss ways the client can use distraction when gratification must be delayed;
discuss alternative ways the client can express feelings without an exaggerated
response.
4. What community resources or referrals would be beneficial for Susan?
Family and community support services, vocational/career counseling, and selfhelp group.