In the continuation phase of treatment for major depressive disorder, what should a nurse emphasize to the client?

Choice A reason: Requiring frequent reassurance and an inability to make decisions independently are hallmark characteristics of dependent personality disorder. Individuals with paranoid personality disorder, by contrast, are often pathologically independent and reluctant to rely on others because they do not trust the motives or competence of those around them.

Choice B reason: An inflated sense of self, grandiosity, and a constant need for admiration are primary clinical features of narcissistic personality disorder. While a paranoid individual may appear rigid or self-centered, their behavior is driven by a defensive posture against perceived external threats rather than a primary desire for ego-inflation or social status.

Choice C reason: The defining characteristic of paranoid personality disorder is a pervasive and unwarranted distrust and suspiciousness of others. These individuals interpret the motives of others as malevolent, often believing without sufficient evidence that they are being exploited, harmed, or deceived by friends, family, and healthcare providers.

Choice D reason: A lack of feelings of remorse and a blatant disregard for the rights of others are core diagnostic criteria for antisocial personality disorder. While individuals with paranoid personality disorder may be socially abrasive or hostile, their actions are typically rooted in perceived self-defense against imagined conspiracies rather than a predatory lack of conscience.

To calculate the volume of medication to be administered, the nurse should use the standard dosage formula: (Desired Dose / Have Dose) x Volume = Amount to Administer. In this clinical scenario, the prescribed amount (Desired) is 7.5 mg, and the concentration on hand (Have) is 5 mg per 1 mL.

Calculation:

Formula: (7.5 mg / 5 mg) x 1 mL = X

Step 1: 7.5 divided by 5 equals 1.5.

Step 2: 1.5 multiplied by 1 mL equals 1.5 mL.

The nurse must accurately draw up 1.5 mL of the diazepam solution into the syringe to provide the exact 7.5 mg dose ordered by the physician.

Choice A reason: This is the mathematically correct volume derived from dividing the prescribed 7.5 mg by the concentration of 5 mg/mL. Accurate calculation is vital in intravenous administration to ensure therapeutic efficacy while avoiding the respiratory depression associated with benzodiazepine toxicity.

Choice B reason: A volume of 0.5 mL would only provide 2.5 mg of diazepam (0.5 mL x 5 mg/mL). This is an under-dose of the prescribed 7.5 mg, which would likely fail to produce the necessary pharmacological effect for the patient's condition.

Choice C reason: A volume of 1.0 mL would provide exactly 5 mg of diazepam. This does not meet the provider's order of 7.5 mg, resulting in a sub-therapeutic dose that could compromise the management of acute anxiety or seizure activity.

Choice D reason: A volume of 2.5 mL would provide 12.5 mg of diazepam (2.5 mL x 5 mg/mL). This constitutes a significant medication error and overdose, increasing the risk of severe central nervous system depression, hypotension, and potential respiratory arrest.