A. Ask the provider for a PRN prescription for restraints: Restraints should only be used as a last resort when there is an imminent risk of harm to the client or others. In this situation, it is essential to first attempt to manage the client's anxiety and behavior through de-escalation strategies and appropriate interventions.
B. Administer diazepam when the client exhibits anxiousness: Diazepam can help manage anxiety and agitation, which is crucial for the client's safety and comfort. Monitoring for signs of anxiety allows for timely intervention with the prescribed medication.
C. Place the client in a room near the nurse's station: Keeping the client close to the nurse's station allows for increased monitoring and ensures that staff can respond quickly if the client's behavior escalates. This helps maintain safety for both the client and others on the unit.
D. Determine if the client is experiencing command hallucinations: Assessing for command hallucinations is important, especially given the client's recent aggressive behavior. Understanding the presence of such hallucinations can guide the treatment plan and safety measures.
E. Establish clear limits for expected behaviors: Setting clear expectations for behavior helps the client understand acceptable conduct and promotes a safer environment. This can be particularly important for clients with paranoid personality disorder who may struggle with interpersonal relationships.

A. Strict parental guidelines contribute to the development of personality disorders: While parenting styles can influence personality development, strict parental guidelines alone are not a direct cause of personality disorders. A range of genetic, environmental, and psychological factors contribute to the development of these disorders.
B. Personality disorders are often seen in children under the age of 10: Personality disorders are generally not diagnosed in children under the age of 10, as personality development is still ongoing. Most personality disorders are diagnosed in adolescence or adulthood after personality traits have stabilized.
C. Childhood emotional trauma, such as abuse or neglect, can significantly influence personality development and contribute to the emergence of personality disorders later in life. Traumatic experiences can lead to maladaptive coping mechanisms and dysfunctional relationships, further perpetuating the characteristics of personality disorders as the individual matures.
D. Clients of higher socioeconomic status are less likely to be diagnosed with personality disorders: Socioeconomic status does not determine the likelihood of being diagnosed with personality disorders. These disorders can affect individuals across all socioeconomic backgrounds, and prevalence is not necessarily linked to wealth or social class.

A. Lack of feelings of remorse: This finding is more characteristic of antisocial personality disorder rather than paranoid personality disorder. Individuals with paranoid personality disorder may feel justified in their suspicions but do not typically lack remorse for their actions.
B. Inflated sense of self: An inflated sense of self is associated with narcissistic personality disorder. Individuals with paranoid personality disorder may have self-doubt but often feel their beliefs and perceptions are valid.
C. Requiring frequent reassurance from others: This behavior is more typical of dependent personality disorder. Individuals with paranoid personality disorder are generally distrustful of others and may not seek reassurance due to their suspicious nature.
D. Suspiciousness of others: This is a key characteristic of paranoid personality disorder. Individuals with this disorder often exhibit a pervasive distrust and suspiciousness of others, interpreting their motives as malevolent. This finding is expected when assessing a client with paranoid personality disorder.

A. A history of schizophrenia: Schizophrenia is a distinct mental health disorder characterized by psychosis, including delusions and hallucinations. While it may co-occur with dissociative disorders, it is not considered a direct risk factor for dissociative identity disorder (DID).
B. Borderline personality disorder: While there is some overlap in symptoms between borderline personality disorder and dissociative identity disorder, borderline personality disorder itself is not a risk factor for developing DID. However, individuals with DID may also present with features of borderline personality disorder.
C. History of trauma during the developmental years: This is a significant risk factor for the development of dissociative identity disorder. DID is often associated with severe trauma, particularly during childhood, such as physical, emotional, or sexual abuse. The disorder can serve as a coping mechanism to dissociate from the traumatic experiences.
D. A history of self-injurious behavior: Self-injurious behavior may be a symptom associated with various mental health disorders, including borderline personality disorder, but it is not specifically identified as a risk factor for dissociative identity disorder.

A. Dependent personality disorder: This personality disorder is classified as part of Cluster C, characterized by anxious and fearful behaviors. Individuals with Dependent personality disorder exhibit a pervasive and excessive need to be taken care of, leading to submissive and clinging behaviors. They often struggle with making decisions without excessive advice and reassurance from others, which can significantly impact their relationships and functioning.
B. Antisocial personality disorder: Antisocial personality disorder is part of Cluster B, which includes dramatic, emotional, or erratic behaviors. Antisocial personality disorder is characterized by a disregard for the rights of others and a lack of empathy. Individuals may engage in deceitful behavior and may have a history of criminal activities, demonstrating a pattern of violating societal norms.
C. Borderline personality disorder: Borderline personality disorder is classified under Cluster B. It is characterized by instability in relationships, self-image, and emotions, as well as impulsive behaviors. Individuals with this disorder often experience intense emotional fluctuations and may engage in self-destructive behaviors, making it difficult to maintain stable relationships and a consistent sense of identity.
D. Paranoid personality disorder: Paranoid personality disorder is classified under Cluster A personality disorders, which include odd or eccentric behaviors. Paranoid personality disorder involves a pervasive distrust and suspiciousness of others. Individuals often interpret benign actions as malevolent, leading to significant challenges in social and interpersonal relationships due to their chronic skepticism and suspicion.

A. Co-occurring mental health illnesses are rarely diagnosed: Individuals with schizophrenia often experience additional mental health conditions, such as anxiety, depression, or substance use disorders. These comorbidities can complicate treatment and recovery, making it essential for healthcare providers to address both schizophrenia and any co-occurring conditions simultaneously.
B. Diagnosis typically occurs after 40 years of age: Schizophrenia usually presents in late adolescence to early adulthood, typically between the ages of 16 and 30. While there are cases of late-onset schizophrenia, it is relatively uncommon, and most individuals are diagnosed much earlier in life.
C. Life expectancy is greater than the general population: Individuals with schizophrenia tend to have a lower life expectancy compared to the general population. This is often attributed to a higher prevalence of comorbid medical conditions, lifestyle factors, and an increased risk of suicide, all of which contribute to a reduced overall life span.
D. The need for resources increases as the disease progresses into adulthood: As schizophrenia progresses, individuals may require increased support to manage their symptoms and maintain daily functioning. This can include access to mental health services, medication management, vocational training, housing assistance, and social support networks. As symptoms become more pronounced or chronic, the demand for these resources tends to grow, making it crucial for individuals and their families to seek help and utilize available services effectively.

A. Dissociative amnesia: This diagnosis involves a loss of memory for personal information or events, typically following trauma or stress. It does not relate to intentionally causing injuries or symptoms.
B. Factitious disorder: Individuals with factitious disorder intentionally produce or feign physical or psychological symptoms to assume the role of a sick person. This behavior can include causing self-harm, such as breaking bones, to gain attention, sympathy, or care from others. The client's actions align with this diagnosis.
C. Illness anxiety disorder: Previously known as hypochondriasis, this disorder involves excessive worry about having a serious illness despite having no significant medical evidence. Individuals with this disorder do not intentionally cause harm to themselves; rather, they focus on perceived health concerns.
D. Functional neurological symptom disorder: This disorder involves neurological symptoms that cannot be explained by medical conditions. While individuals may have genuine neurological symptoms, they do not typically engage in self-harm or intentionally inflict injuries as seen in factitious disorder.

A. Symptoms of major depression or mania: Schizoaffective disorder is characterized by the presence of mood disorder symptoms (such as major depression or mania) in conjunction with symptoms of schizophrenia, including delusions or hallucinations. During the active phase of schizoaffective disorder, individuals experience both psychotic symptoms and significant mood disturbances.
B. Absence of delusions or hallucinations: In schizoaffective disorder, delusions and hallucinations are present alongside mood symptoms. Therefore, the absence of these psychotic symptoms does not characterize the active phase.
C. More severe negative symptoms: While schizoaffective disorder can have negative symptoms, such as emotional flattening or lack of motivation, the emphasis is more on the co-occurrence of mood symptoms rather than solely on negative symptoms.
D. Anosognosia is more severe: Anosognosia refers to a lack of awareness of one's own illness. While it can occur in both schizophrenia and schizoaffective disorder, the severity of anosognosia is not a distinguishing factor specifically associated with the active phase of schizoaffective disorder.

A. To treat pain and ease anxiety: The client has a history of chronic back pain due to a gymnastics injury and a previous diagnosis of anxiety. It is common for individuals with chronic pain conditions to be prescribed opioids for pain relief. Additionally, those experiencing anxiety may misuse opioids to self-medicate and achieve temporary relief from their symptoms, leading to the development of an opioid use disorder.
B. To promote sleep and rest: While some individuals may use opioids in an attempt to promote sleep, this option does not directly address the client's specific history of chronic pain and anxiety. It is less likely to be a primary reason for starting opioid use compared to treating pain and anxiety.
C. Because they witnessed their parents using drugs or alcohol to cope: Although witnessing parental substance use can influence a person's behavior, there is no indication in the provided information that the client has this background. Therefore, this is not a clear underlying reason for the client's opioid use.
D. To treat hallucinations and perform better at work: There is no mention of the client experiencing hallucinations, and the context suggests that the client is struggling academically rather than seeking to perform better at work. This option does not align with the client's situation or history.

A. Blood pressure: The blood pressure reading of 132/38 mm Hg is noteworthy, particularly the low diastolic value, but it does not specifically indicate negative symptoms of schizophrenia. It may require further monitoring, but it is not a direct reflection of the negative symptomatology.
B. Lack of motivation: The client's refusal to eat, drink, or participate in therapy sessions indicates a lack of motivation, which is a classic negative symptom of schizophrenia. This symptom reflects diminished drive and engagement in everyday activities.
C. Change in behavior: The client's prolonged withdrawal and limited interaction with others are significant changes from their previous functioning and can be considered negative symptoms. These changes often manifest as a decrease in social interaction and activities.
D. Lack of energy: While the client appears to have slow movements and may seem fatigued, "lack of energy" is a vague term. However, the slowed movements can indicate negative symptoms associated with schizophrenia. The more specific term would be lack of motivation or social withdrawal.
E. Withdrawn: The client's withdrawal from social interactions and activities is a clear indicator of negative symptoms. This behavior demonstrates a lack of interest in engaging with others and reflects the emotional and social deficits often seen in schizophrenia.