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 into the plan of care?

Choice A reason: Providing additional attention may inadvertently reinforce maladaptive behaviors in clients with borderline personality disorder. These individuals often struggle with emotional regulation and may engage in self-harm to elicit attention or care. Nursing interventions should focus on consistency and boundaries rather than increased attention. Choice B reason: Mechanical restraints are a last resort and should only be used when the client poses an immediate threat to themselves or others. Using restraints preemptively before medication administration is inappropriate and violates ethical and legal standards of care. Choice C reason: Obtaining a verbal contract for safety is a therapeutic strategy that promotes client accountability and collaboration. It helps the client commit to seeking help before engaging in self-harm and fosters trust and autonomy within the therapeutic relationship. Choice D reason: Using consistent staff members is beneficial for establishing trust and stability, but it is not the most direct intervention for preventing self-mutilation. While helpful, it does not specifically address the immediate risk of self-harm.