A client with borderline personality disorder has been hospitalized several times after self-mutilating
episodes. The client has been assessed as demanding, impulsive, and immature.
The client has
entered dialectical behavior therapy on an outpatient basis. The priority focus for counseling is
a. anger control assistance.
b. risk for self-mutilation.
c. risk for trauma.
d. powerlessness.
B
Risk for self-mutilation is a nursing diagnosis relating to client safety needs and is therefore of high
priority. Options A and D: Anger control assistance and powerlessness may be appropriate foci for
therapeutic work but are not the priority. Option C: Risk for trauma implies accidental injury, which
is not the case for the client with borderline personality disorder.
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