A nurse is reinforcing education to a client who is prescribed clozapine. Which of the following findings should the nurse identify as consistent with agranulocytosis and instruct the client to monitor?

A. "Persistent depressive disorder is a mild chronic form of depression." PDD, previously known as dysthymia, is a long-lasting depressive condition with persistent low mood for at least two years. Symptoms are less severe than major depressive disorder but are continuous and can significantly impact daily life. While not as acute as major depression, PDD requires management through therapy, medication, and lifestyle modifications.
B. "Persistent depressive disorder is characterized by delusions and hallucinations." Psychotic features such as delusions and hallucinations are not typical of persistent depressive disorder (PDD). These symptoms are more commonly associated with major depressive disorder with psychotic features or schizophrenia. PDD primarily involves chronic low-grade depression rather than severe psychotic symptoms.
C. "Persistent depressive occurs shortly after taking or withdrawing from a substance." Substance-induced depressive disorder is a distinct diagnosis that results from drug use or withdrawal. Persistent depressive disorder is not caused by substance use but is a long-term mood disorder that lasts for at least two years. The symptoms are chronic and not directly linked to substance intake or withdrawal.
D. "Persistent depressive is characterized by both manic and depressive episodes." Bipolar disorder, not persistent depressive disorder, is characterized by alternating manic and depressive episodes. PDD involves a chronic, low-level depressive state without manic symptoms. Individuals with PDD may experience periods of worsening depression, but they do not exhibit the high-energy or euphoric states seen in bipolar disorder.

A. Splitting is a defense mechanism commonly used by clients with borderline personality disorder. It involves viewing people or situations as entirely good or entirely bad, leading to rapidly shifting opinions and emotional reactions. This black-and-white thinking can create division among healthcare providers, as the client may idealize one staff member while devaluing another, causing conflict within the team.
B. Reaction formation occurs when a person expresses the opposite of their true feelings, often due to discomfort with their actual emotions. While seen in some personality disorders, it is not a hallmark feature of borderline personality disorder and does not typically contribute to team division.
C. Denial involves refusing to acknowledge reality or facts that cause distress. Though common in various mental health conditions, it does not specifically create division among healthcare providers in the way splitting does. Clients with borderline personality disorder may use denial, but it is not their primary defense mechanism.
D. Regression is a defense mechanism where an individual reverts to earlier developmental behaviors in response to stress. While it can be seen in borderline personality disorder, it does not typically lead to splitting within the healthcare team, as it primarily affects the client’s own coping mechanisms rather than interpersonal dynamics.