A client with borderline personality disorder gives written notice of intention to leave the hospital after a voluntary admission. The client tells the nurse, "I will rescind my notice if you expand my smoking privileges

Question

" The nurse should respond in a way that: 1. Convinces the client to rescind the notice.
2. Provides exceptions to the unit rules.
3. Refers the client to the physician.
4. Consistently reinforces the unit rules.

Answer 1

4
Rationale: The client is exhibiting manipulation. The nurse should incorporate clear, concise, and consistent limit setting and directions. When infractions of the rules or manipulative behavior occur, apply consequences immediately. Responding consistently to the manipulative behavior will help gradually lessen its intensity. It would encourage staff splitting to refer the client to the physician. Attempting to coerce a client to change, or allowing rule exceptions, is nontherapeutic and counterproductive.