Registered Practical Nurse (RPN) Practice Test

During the initial assessment of a client with borderline personality disorder, what history should the nurse specifically inquire about?

1. Substance abuse

2. Stable relationships

3. Unstable insecure attachments

4. Previous hospitalizations

The correct answer is: Unstable insecure attachments

Inquiring about unstable insecure attachments during the initial assessment of a client with borderline personality disorder is important because this condition is characterized by significant instability in interpersonal relationships, self-image, and emotions. Clients often have a history of intense and tumultuous relationships that can fluctuate between idealization and devaluation. This pattern can lead to feelings of abandonment and a deep-seated fear of rejection, which significantly impact their behavior and coping strategies. Understanding the client's attachment history can help the nurse develop an effective care plan that addresses these relationship dynamics and the emotional distress associated with them. Other aspects of the client’s history, such as substance abuse, stable relationships, or previous hospitalizations, may be relevant but do not directly address the core features of borderline personality disorder in the same way that unstable insecure attachments do. While these other factors can influence the overall clinical picture, the focus on attachment patterns is particularly crucial, as they are central to understanding the client's relational difficulties and their emotional regulation challenges.