A nurse is assisting in the care of a client who has persistent depressive disorder. When reinforcing education to the client about their illness, which of the following statements should the nurse make?

A. Voice tremors are associated with moderate anxiety, where the individual begins to exhibit physical signs of distress but still retains some level of focus. At panic-level anxiety, communication becomes severely impaired, often resulting in unintelligible speech or complete loss of verbal ability.
B. Depersonalization, a dissociative symptom in which individuals feel detached from their own body or reality, is a hallmark of panic-level anxiety. During this state, individuals may experience a sense of unreality, feel as though they are outside their body, or believe that their surroundings are distorted, contributing to a profound sense of fear and disorientation.
C. Shakiness is a physiological response observed in moderate to severe anxiety due to increased autonomic arousal. However, at panic-level anxiety, the body is in a state of extreme crisis, often leading to more severe symptoms such as hyperventilation, loss of motor control, and derealization rather than mere shakiness.
D. Poor concentration is characteristic of moderate to severe anxiety, where cognitive function begins to decline due to excessive worry. However, in panic-level anxiety, cognitive function is severely impaired, and the individual may be unable to process information coherently, often leading to complete disorganization of thought.

A. "Medication compliance.": While medications can help manage mood instability or co-occurring conditions like depression or anxiety, they are not the primary treatment for borderline personality disorder (BPD). The primary focus should be on addressing immediate safety concerns, including self-harm and suicidal tendencies, which are more urgent.
B. "Awareness of potential for self-harm.": Clients with BPD frequently engage in self-harming behaviors or suicidal gestures due to emotional dysregulation, impulsivity, and intense fear of abandonment. Educating the family about recognizing warning signs, providing emotional support, and ensuring access to crisis intervention resources is critical for reducing risk and promoting safety.
C. "Information about insurance coverage.": While understanding insurance coverage can help in accessing long-term treatment, it is not the most urgent need when addressing the safety of a client newly diagnosed with BPD. Immediate interventions should focus on risk assessment and prevention of harmful behaviors.
D. "Resources for group therapy in the community.": Group therapy, such as dialectical behavior therapy (DBT), can be beneficial for long-term symptom management, but in the early stages of diagnosis, ensuring the family's awareness of self-harm risks and how to intervene in a crisis takes priority over therapy referrals.