A nurse is reinforcing teaching to a client who is to undergo transcranial magnetic stimulation (TMS) for depression. Which of the following information should the nurse provide?

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. Diagnosis typically occurs after 40 years of age. Diagnosis typically occurs in late adolescence to early adulthood, not after 40 years of age. While late-onset schizophrenia can occur, it is less common. The disorder usually manifests in the late teens to early 30s, with males often presenting earlier than females.
B. Life expectancy is greater than the general population. Life expectancy is lower than the general population due to factors such as increased risk of suicide, cardiovascular disease, and reduced access to healthcare. The presence of comorbid conditions and lifestyle factors, including smoking and poor diet, further contribute to a shorter lifespan.
C. Co-occurring mental health illnesses are rarely diagnosed. Co-occurring mental health illnesses are frequently diagnosed in individuals with schizophrenia. Conditions such as depression, anxiety disorders, and substance use disorders are common. These comorbidities can complicate treatment and impact overall prognosis.
D. The need for resources increases as the disease progresses into adulthood. The need for resources increases as the disease progresses into adulthood due to worsening functional impairment. Individuals with schizophrenia often require long-term support, including medication management, social services, and rehabilitation programs to maintain stability and quality of life.