A nurse is admitting a client who has borderline personality disorder and is at risk for self-mutilation. Which of the following interventions should the nurse incorporate in the plan of care?

A. Provide additional attention to the client. Clients with borderline personality disorder (BPD) often engage in self-harm as a way to cope with emotional distress or gain attention. While monitoring is important, excessive attention can reinforce maladaptive behaviors. A structured approach with consistent boundaries is more effective. B. Apply mechanical restraints before administering medication. Restraints should only be used as a last resort when a client is an imminent danger to themselves or others. The first step in preventing self-mutilation is to implement less restrictive interventions, such as verbal contracts, distraction techniques, or therapy. C. Obtain a verbal contract from the client. A verbal or written safety contract (also called a no-harm contract) is an effective tool for clients at risk for self-mutilation. It encourages the client to express distress verbally instead of self-harming and helps them develop alternative coping strategies. However, this should be used alongside close monitoring and therapy. D. Limit staff members who work with the client. While consistency in care is important for clients with BPD, limiting staff interaction may reduce opportunities for therapeutic relationships. Instead, a consistent and structured approach from a trained care team helps build trust and emotional regulation skills.