A patient diagnosed with borderline personality disorder has demonstrated self-mutilation and inappropriate expressions of anger. Which statement by the patient would the nurse evaluate as an improvement?
a. "I think you are the nicest nurse on the unit."
b. "I got drunk last night, but I won't ever do it again."
c. "I felt like cutting myself, so I came to talk to you."
d. "I hate my friends. They never help me when I need it."
C
Ordinarily, the patient would impulsively engage in self-mutilation. When he or she is able to delay the action and seek the more adaptive coping strategy of talking with the nurse, the nurse can correctly evaluate the patient as showing improvement. The other responses suggest use of idealization, manipulation, impulsive behavior, and devaluation, all symptomatic of the disorder.
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