A nurse in an outpatient mental health facility is preparing to administer phenelzine to a client who has been taking this medication for several years. The client reports eating a grilled cheese sandwich and a banana for lunch and is feeling dizzy. Which of the following vital signs should the nurse assess first?

Choice A reason: Identifying when the client engages in splitting behaviors is more relevant to borderline personality disorder than schizoid personality disorder. Splitting is a defense mechanism where individuals fail to integrate positive and negative aspects of self and others into cohesive images. People with schizoid personality disorder typically exhibit detachment from social relationships and a restricted range of emotional expression, not splitting.

Choice B reason: Giving the client a choice of solitary activities aligns with the characteristics of schizoid personality disorder. Individuals with this disorder often prefer to engage in activities alone, as they feel more comfortable being by themselves than in social situations. Providing options for solitary activities can help meet the client's needs for privacy and personal space while also respecting their autonomy.

Choice C reason: Setting limits on the client's need for constant social contact is not applicable to schizoid personality disorder. In fact, individuals with this disorder typically do not desire social contact and may already isolate themselves. The intervention would be more appropriate for disorders where the individual seeks excessive social interaction.

Choice D reason: Assisting the client in identifying sources of anger may not be a priority in the care of someone with schizoid personality disorder unless there is a specific indication for it. These individuals often do not express emotions openly and may not experience or show anger in the same way as those without the disorder. The focus should be on interventions that respect the client's emotional expression, or lack thereof.

Choice A reason: Donepezil is often administered before bedtime to reduce the risk of nausea, which is a common side effect. Taking it at bedtime can also coincide with the body's natural rest period, potentially minimizing the impact of any side effects.

Choice B reason: Alzheimer's disease is a progressive condition, and currently, there is no cure. The provider will not decrease the dose as the disease improves because the disease typically worsens over time. Medication management may change, but it is based on symptom control, not improvement of the disease.

Choice C reason: Donepezil does not stop the progression of Alzheimer's disease. It can help manage symptoms and improve quality of life, but it does not cure or halt the disease's progression.

Choice D reason: Donepezil does not decrease the risk of falls. In fact, some of its side effects, such as dizziness, may increase the risk of falls. It is important for caregivers to monitor their partners for such side effects and take precautions to prevent falls.