Sleep disturbances are commonly seen in depression.

Choice A reason: Crying loudly when requests are denied is more consistent with histrionic personality disorder, where individuals display exaggerated emotional responses to gain attention. It does not reflect the core features of avoidant personality disorder.

Choice B reason: Showing no remorse after harming another person’s property is characteristic of antisocial personality disorder, where disregard for others’ rights and lack of guilt are common. This is not aligned with avoidant personality disorder.

Choice C reason: Multiple failed marriages may be associated with borderline personality disorder due to unstable relationships and fear of abandonment. It is not a defining feature of avoidant personality disorder.

Choice D reason: Avoidant personality disorder is characterized by hypersensitivity to criticism, fear of rejection, and social inhibition. The observation that the client fears criticism from staff directly supports this diagnosis, as it reflects the pervasive anxiety and avoidance behaviors typical of the disorder.

Choice A reason: Drinking alcohol every morning to calm nerves and stop tremors indicates physical dependence. Tremors are a withdrawal symptom, and the need to drink to relieve them shows tolerance and dependence. Additionally, psychological addiction is present because the client believes alcohol is necessary to function. Chronic alcohol use also predisposes to neurologic disorders such as peripheral neuropathy and Wernicke-Korsakoff syndrome.

Choice B reason: While the client may have underlying anxiety, the key issue is the dependence on alcohol to manage symptoms. The behavior described is more consistent with addiction and withdrawal rather than a primary anxiety disorder.

Choice C reason: Alcohol can contribute to cardiovascular problems such as hypertension or arrhythmias, but the immediate risk described in the scenario is dependence and neurologic complications, not cardiovascular disease.

Choice D reason: Chronic alcohol use can lead to nutritional deficiencies, especially thiamine deficiency, but the client’s daily drinking to stop tremors is more directly indicative of dependence and addiction rather than nutritional deficiency alone.