A nurse on a mental health unit is discussing consent with a newly licensed nurse. Which of the following information should the nurse include?

Choice A reason: Unevenness in shoulders, hips, and ribs is a hallmark of scoliosis, resulting from lateral spinal curvature altering body alignment. This asymmetry, visible on physical exam, stems from vertebral rotation and is a key diagnostic feature, reflecting structural changes in the spine.

Choice B reason: Asymmetry of the spine, seen as lateral deviation on imaging, is a defining feature of scoliosis. Vertebral misalignment causes visible deformities, like rib humps, due to rotational forces, making this a primary symptom used in diagnosis and severity assessment.

Choice C reason: Curvature of the spine itself is the core characteristic of scoliosis, measured by Cobb’s angle on X-rays. This lateral deviation, often idiopathic, distinguishes scoliosis from normal spinal alignment, making it a fundamental symptom for diagnosis and treatment planning.

Choice D reason: Insomnia is not a hallmark of scoliosis. While severe scoliosis may cause discomfort affecting sleep, it is not a primary symptom. Scoliosis primarily involves structural spinal changes, not neurological or psychological effects like insomnia, making this choice incorrect.

Choice E reason: Decreased appetite is not associated with scoliosis. Scoliosis affects spinal alignment, not metabolic or gastrointestinal functions. Appetite changes may occur in other conditions but are not a hallmark of scoliosis’s musculoskeletal presentation, making this choice irrelevant.

Choice A reason: Taking art lessons to relieve stress suggests a healthy coping mechanism, not a substance use disorder. Alcohol use disorder involves impaired functioning, like work performance, not positive activities like art, which indicates adaptive behavior rather than addiction.

Choice B reason: Loss of appetite can indicate alcohol use disorder, as chronic alcohol consumption disrupts appetite-regulating hormones (e.g., ghrelin) and causes gastrointestinal irritation, reducing desire to eat. Combined with work reprimands from drinking, this suggests impaired functioning, a hallmark of substance use disorder.

Choice C reason: Being focused with many goals does not indicate a substance use disorder, which typically impairs concentration and goal-directed behavior due to alcohol’s neurotoxic effects. This statement suggests intact functioning, inconsistent with the negative consequences described in the scenario.

Choice D reason: Having supportive friends is a positive factor, not indicative of substance use disorder. Alcohol use disorder often leads to social isolation or strained relationships, not reliance on a support system, making this statement unrelated to addiction criteria.