A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? Select all that apply.

A. Provide fluids and monitor electrolytes to prevent dehydration: Hydration and electrolyte balance are important supportive measures in Neuroleptic Malignant Syndrome (NMS), but they are not the immediate priority. The underlying cause, dopamine blockade from antipsychotics, must first be addressed by stopping the offending drug.

B. Increase the dose of haloperidol to manage agitation: Increasing the antipsychotic dose would worsen NMS, as haloperidol and other dopamine antagonists are the main cause. This intervention would intensify muscle rigidity, hyperthermia, and autonomic instability.

C. Withhold the haloperidol and initiate cooling measures: This is the priority action. Immediate discontinuation of the antipsychotic removes the trigger, while cooling helps reduce hyperthermia. These steps prevent progression of the life-threatening syndrome and stabilize the client.

D. Administer a dose of acetaminophen to reduce the fever: Acetaminophen may lower temperature in infections, but in NMS the hyperthermia results from severe muscle rigidity and altered hypothalamic regulation. Cooling measures and stopping the medication are more effective interventions than antipyretics alone.

A. A pattern of being excessively preoccupied with orderliness, perfectionism, and control: This describes obsessive-compulsive personality disorder, not borderline personality disorder. While both involve maladaptive behaviors, BPD is characterized by instability rather than rigidity and control.

B. A history of manipulating others for personal gain and lack of empathy: These traits are consistent with antisocial personality disorder. Clients with BPD may display manipulation, but it is usually driven by fear of abandonment rather than exploitation for gain.

C. A persistent fear of criticism and rejection, leading to social withdrawal: This describes avoidant personality disorder, which is marked by social inhibition and sensitivity to rejection. In contrast, clients with BPD struggle with unstable relationships and emotional regulation.

D. A pattern of unstable interpersonal relationships, self-image, and along with marked impulsivity: Clients often demonstrate intense but unstable relationships, shifting self-image, impulsivity, and emotional dysregulation that can lead to risky behaviors and self-harm.