A nurse is caring for a client who has an alcohol use disorder. Which of the following manifestations should the nurse expect the client to have during withdrawal?

Choice A reason: Mechanical restraints are a last resort due to risks of physical and psychological harm. Premature restraint escalates agitation in a client with a violence history, as it may trigger a fight-or-flight response. De-escalation techniques, like verbal exploration, are prioritized to ensure safety.

Choice B reason: Standing directly in front of an angry client can be perceived as confrontational, increasing the risk of violence. Maintaining a safe distance and non-threatening posture reduces tension, as close proximity may heighten arousal in a client with a history of violent behavior.

Choice C reason: Asking the client to describe feelings promotes verbal expression, de-escalating anger by addressing its source. This therapeutic approach reduces arousal by engaging the prefrontal cortex, helping the client process emotions and preventing escalation to violence in a group therapy setting.

Choice D reason: Therapeutic touch can escalate agitation in an angry client, especially with a violence history, as it may be perceived as intrusive. Physical contact increases arousal in heightened states, risking aggressive responses, making verbal de-escalation a safer and more effective intervention.

Choice A reason: Taking advantage of others is characteristic of antisocial personality disorder, not paranoid personality disorder. Paranoid individuals exhibit mistrust and suspicion, not manipulative behavior, as their primary issue is hypervigilance due to perceived threats, not exploitation.

Choice B reason: Paranoid personality disorder involves pervasive mistrust, with clients believing others are deceiving or exploiting them. This stems from cognitive biases and heightened amygdala activity, leading to hypervigilance and suspicion, a core diagnostic criterion expected in assessment.

Choice C reason: Exaggerated emotional expression is typical of histrionic personality disorder, not paranoid. Paranoid individuals may display restricted affect due to mistrust, not dramatic emotions, as their focus is on perceived threats rather than seeking attention through emotional displays.

Choice D reason: Detachment is more associated with schizoid personality disorder, not paranoid. Paranoid individuals engage with others but with suspicion and hostility, driven by fear of betrayal, not emotional withdrawal, distinguishing their interpersonal style from detached behaviors.