A client with borderline personality disorder tells a nurse, "I'm afraid to get on a train because we'll probably get into a wreck." Which response by the nurse would be most appropriate?
A) "Have you had a bad experience riding a train?"
B) "What are the chances of that actually happening?"
C) "Now, you know that won't happen."
D) "Have you thought about going by automobile?"
Ans: B
The nurse should challenge the client's dysfunctional thinking by encouraging the client to think about the event or situation in a different way, providing the client with a different perspective to consider. Although asking about a previous bad experience may help shed some light on the situation, the client with borderline personality disorder has dysfunctional thinking, and this needs to be addressed. Telling the client that he or she knows it won't happen or suggesting the client travel by car does not address the client's underlying pattern of thinking.
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