A nurse is reinforcing education to a newly licensed nurse about comorbidities associated with cluster B personality disorders. The nurse should identify which of the following disorders as a comorbidity?

A. Increased cheerfulness, increased energy, helping other nurses on the shift. While mood changes can sometimes indicate a problem, increased cheerfulness and willingness to help others are not specific red flags for substance use disorder. Substance use is more commonly associated with erratic behavior, frequent absences, or medication discrepancies.
B. Increased irritability towards supervisors, outspokenness regarding work issues, increased attendance at staff meetings. Frustration with workplace issues and increased engagement in staff meetings do not necessarily indicate substance use disorder. Behavioral concerns related to substance use often include impaired judgment, frequent errors, or missing narcotics.
C. Volunteering for overtime on a continual basis, avoiding having a witness to wasting narcotics, needing to be alone in the medication room when preparing medications. Consistently seeking extra shifts, avoiding witnesses when handling narcotics, and needing to be alone while preparing medications suggest possible drug diversion. These behaviors align with common patterns seen in healthcare professionals struggling with substance use disorders.
D. Crying, sharing personal details of relationship problems, monopolizing conversations. Emotional distress and oversharing personal issues may indicate stress or burnout rather than substance use disorder. Substance use concerns are more closely tied to inconsistent work performance, medication discrepancies, and altered behavior related to drug access.

A. Exhaustion phase. The exhaustion phase occurs when the body's ability to cope with stress is depleted, leading to physical and psychological impairments such as fatigue, burnout, and increased susceptibility to illness. This phase does not align with maintaining performance over an extended period.
B. Alarm phase. The alarm phase is the initial reaction to stress, activating the sympathetic nervous system and triggering the "fight-or-flight" response. While it provides a short-term boost in alertness and energy, it is not sustainable for weeks to months without impairment.
C. Resistance phase. The resistance phase allows the body to adapt to prolonged stress, maintaining homeostasis and function without significant observable impairment. During this phase, the individual continues to perform duties effectively despite ongoing stress.
D. Adaptive phase. The General Adaptation Syndrome does not include an "adaptive phase." Adaptation occurs within the resistance phase, making this answer incorrect.