A nurse is assessing a client who states that she becomes extremely anxious in social gatherings. She tells the nurse that she never feels "good enough" for her coworkers.
The nurse should identify that these findings can indicate which of the following personality disorders.

Choice A rationale

Spironolactone is a potassium-sparing diuretic. Its mechanism of action involves blocking aldosterone receptors in the kidney's distal convoluted tubule and collecting duct, leading to increased sodium and water excretion while retaining potassium. Consequently, taking a potassium supplement concurrently would dangerously increase the risk of hyperkalemia, a condition characterized by high blood potassium levels (normal range is 3.5-5.0 mEq/L), which can cause life-threatening cardiac dysrhythmias.

Choice B rationale

Spironolactone's primary effect is on sodium and potassium balance, not calcium. Calcium supplements do not typically interact with spironolactone in a way that would cause a significant, adverse change in calcium levels. The nurse should instruct the client to avoid supplements that directly alter the electrolytes affected by the medication's mechanism of action.

Choice C rationale

Spironolactone does not significantly impact iron metabolism. Therefore, a client taking an iron supplement would not be at increased risk of an adverse interaction. Iron supplements are generally well-tolerated with spironolactone, and there is no contraindication for their concurrent use. The focus of client teaching should be on electrolytes directly affected by the medication.

Choice D rationale

Spironolactone does not have a direct or clinically significant interaction with magnesium supplements. While diuretics can sometimes affect magnesium levels, spironolactone's primary action is on potassium and sodium. Therefore, there is no major contraindication for the use of magnesium supplements, unlike the life-threatening risk associated with potassium supplementation. *.

Choice A rationale

Histrionic personality disorder is characterized by a pervasive pattern of excessive emotionality and attention-seeking behavior. Individuals with this disorder often feel uncomfortable when not the center of attention and may use dramatic, theatrical, or seductive behaviors to attract others. They are not typically withdrawn or anxious in social settings.

Choice B rationale

Avoidant personality disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. The client's statements of becoming "extremely anxious in social gatherings" and never feeling "good enough" for coworkers are hallmark symptoms of this disorder. They actively avoid social situations to prevent rejection.

Choice C rationale

Obsessive-compulsive personality disorder is characterized by a preoccupation with orderliness, perfectionism, and mental and interpersonal control. Individuals with this disorder are often rigid and inflexible. They are not typically described as being socially anxious due to feelings of inadequacy, but rather due to a need for control.

Choice D rationale

Borderline personality disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, and marked impulsivity. While individuals with this disorder may experience intense anxiety and fear of abandonment, their core features are related to instability, not a pervasive feeling of not being "good enough" in social settings. .