A nurse in a mental health clinic is taking a medical history on a client. The nurse should recognize that which of the following factors in the client's history increases their risk for mental illness?

A. Seeking a tutor for help with a challenging class. Seeking academic support is a positive coping strategy and does not indicate a risk for suicide. Students struggling with schoolwork may experience stress, but tutoring reflects problem-solving behavior and a willingness to improve academically.
B. Volunteering to serve food at a homeless shelter over the holidays. Engaging in community service is generally a sign of social involvement and purpose. While sudden changes in behavior could be concerning, volunteering itself is not a warning sign of suicide and may indicate a sense of fulfillment.
C. Displaying extreme mood swings. Extreme mood swings can indicate emotional instability, a key warning sign of suicide. Drastic changes in mood, especially from deep sadness to sudden calmness, may suggest suicidal intent and should be taken seriously by caregivers and peers.
D. Making plans to go to the prom. Making future plans typically reflects hope and engagement in life. However, if a student suddenly makes farewell plans, withdraws from social activities, or gives away belongings, it may be a concerning sign that requires further assessment.

A. Paranoia is a positive symptom of schizophrenia, characterized by excessive distrust and suspicion. Positive symptoms involve an excess or distortion of normal functions, such as hallucinations or delusions. Paranoia reflects an altered perception of reality rather than a diminished emotional or cognitive function.
B. Distorted beliefs, including delusions, are considered positive symptoms of schizophrenia. These beliefs are false, fixed, and not based on reality, often involving grandiosity, persecution, or somatic concerns. Positive symptoms represent an exaggeration of normal thought processes rather than a reduction in function.
C. Confusion is often associated with cognitive impairment in schizophrenia but is not classified as a negative symptom. Cognitive symptoms include deficits in memory, attention, and executive function, whereas negative symptoms involve the absence of normal emotional or behavioral responses. Confusion is more related to disorganized thinking rather than a loss of function.
D. Lack of emotions, or affective flattening, is a negative symptom of schizophrenia. Negative symptoms involve a reduction in normal functions, such as diminished emotional expression, social withdrawal, and decreased motivation. These symptoms contribute significantly to functional impairment and are often more resistant to treatment than positive symptoms.