A hospitalized client diagnosed with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which medication would the nurse expect to administer?

Choice A reason: Auditory hallucinations are positive symptoms of schizophrenia, driven by mesolimbic dopamine excess, causing sensory perceptions without stimuli. They reflect hyperactive neural signaling, not the diminished motivation or functioning characteristic of negative symptoms, making this incorrect.

Choice B reason: Threatening behavior is a positive symptom, reflecting dopamine-driven impulsivity and agitation in schizophrenia’s mesolimbic pathway. Negative symptoms involve deficits like apathy, not active behaviors, making this choice unrelated to negative symptom criteria.

Choice C reason: Delusions of grandeur are positive symptoms, stemming from excessive dopamine in the mesolimbic system, causing exaggerated beliefs. Negative symptoms involve reduced emotional or behavioral expression, not active psychotic beliefs, making this choice incorrect.

Choice D reason: Poor personal hygiene is a negative symptom of schizophrenia, reflecting reduced motivation and self-care due to prefrontal cortex dopamine hypofunction. This deficit in volition and functioning aligns with negative symptoms, distinguishing it from positive symptoms like hallucinations.

Choice A reason: Marriage counseling addresses situational crises like divorce, not maturational crises, which involve developmental transitions. It targets interpersonal conflict, not the normative stress of life stages, missing the neuroadaptive challenges of maturational growth like childbirth.

Choice B reason: Recognizing relapse symptoms is relevant for chronic mental illness, not maturational crises. Relapse involves dopamine or serotonin dysregulation, not the normative developmental stress of life transitions, making this intervention unrelated to maturational coping needs.

Choice C reason: Selecting a group home addresses a situational crisis for a troubled teen, not a maturational one. Maturational crises involve normative developmental stages, like childbirth, requiring anticipatory guidance, not reactive interventions for behavioral issues.

Choice D reason: Childbirth classes prepare couples for the maturational crisis of parenthood, a normative life transition. They reduce stress by enhancing prefrontal cortex-mediated coping skills and serotonin-driven emotional regulation, supporting adaptation to developmental changes, making this the best intervention.