A male client is admitted to the unit with a possible diagnosis of delirium. Which statement by the client's wife best supports the diagnosis?

The correct answer is D:

Choice A reason: “If a dose is missed, double the next dose of medication.” This statement is incorrect. Doubling up on a dose can lead to an overdose and serious side effects. Patients are advised to take the missed dose as soon as they remember unless it’s almost time for the next dose.

Choice B reason: “This medication may increase your blood pressure.” Alprazolam is known to have a sedative effect, which can lower blood pressure rather than increase it. Therefore, this statement is not typically accurate.

Choice C reason: “Do not eat aged cheeses while taking this medication.” This dietary restriction is associated with monoamine oxidase inhibitors (MAOIs), which are a different class of medications used to treat depression. Alprazolam does not interact with tyramine-rich foods like aged cheeses, so this statement is not applicable.

Choice D reason: “Use a dependable form of contraception while taking this medication.” Alprazolam falls under FDA Pregnancy Category D, which means there is positive evidence of human fetal risk, but the potential benefits may warrant use in pregnant women despite the risks. Therefore, it is important to use reliable contraception to prevent pregnancy while taking this medication.

The correct answer is Choice A: Give positive feedback when the client is assertive with staff or clients.

Choice A rationale: Clients with dependent personality disorder exhibit a pervasive and excessive need to be taken care of, leading to submissive and clinging behavior. They often struggle with making decisions, expressing their opinions, and engaging in assertive communication. By providing positive feedback when the client exhibits assertive behavior, the nurse reinforces adaptive coping strategies and encourages the development of healthy interpersonal interactions. This approach fosters independence, self-confidence, and autonomy, ultimately promoting a better quality of life for the client.

Choice B rationale: Although setting limits is crucial in managing manipulative behaviors, it is not the primary focus for clients with dependent personality disorder. These clients tend to prioritize pleasing others and avoiding conflict over exploiting or manipulating other individuals. Instead, nurses should emphasize supportive interventions that foster self-reliance and assertiveness.

Choice C rationale: Close monitoring to prevent self-mutilation is not typically associated with the management of dependent personality disorder. This intervention is more relevant for clients with borderline personality disorder or those with a history of self-harm behaviors. Clients with dependent personality disorder may exhibit passive and avoidant behaviors but are less likely to engage in acts of self-mutilation.

Choice D rationale: Discouraging flamboyant or seductive behaviors is an intervention more suited for clients with histrionic personality disorder, not dependent personality disorder. Histrionic personality disorder is characterized by excessive emotionality and attention-seeking behaviors, whereas dependent personality disorder primarily involves a lack of self-confidence and excessive reliance on others for decision-making and emotional support.