A nurse is caring for a client who has social anxiety disorder. The client reports experiencing feelings of anxiousness that disrupt their sleep. Which of the following recommendations should the nurse make?

Choice A reason: While verbalizing an improved mood is a positive outcome, it is not specific to borderline personality disorder and does not directly address the behavioral aspects of the condition.

Choice B reason: Hallucinations are not a typical symptom of borderline personality disorder; they are more commonly associated with psychotic disorders. Therefore, a decrease in hallucinations would not be a relevant treatment outcome for this condition.

Choice C reason:Encouraging personal hygiene supports general self-care but does not target the specific therapeutic goals for borderline personality disorder, which center on interpersonal effectiveness and emotion regulation.

Choice D reason: Teaching the client to articulate needs directly builds assertive communication and interpersonal effectiveness—core competencies in dialectical behavior therapy that reduce maladaptive behaviors and improve relationship stability.

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.