A nurse is caring for a client who frequently attempts to remove his IV catheter. A family member requests that the nurse apply restraints. Which of the following responses should the nurse make?

Choice A reason : Tetany and stiffness of the hands are not typical symptoms of hypothyroidism. Tetany is usually associated with hypocalcemia, which is not a direct result of hypothyroidism⁶.

Choice B reason : Exophthalmos and nervousness are symptoms associated with hyperthyroidism, not hypothyroidism. Exophthalmos, the bulging of the eyes, is particularly associated with Graves' disease, a type of hyperthyroidism⁶.

Choice C reason : Extreme fatigue and hair loss are common symptoms of hypothyroidism. The condition can lead to a slowing down of the body's metabolic processes, resulting in fatigue. Hair loss is also a frequent complaint due to the effects of reduced thyroid hormone levels on hair follicles⁶⁷⁸.

Choice D reason : Profuse sweating and flushed skin are more indicative of hyperthyroidism or other conditions, not hypothyroidism. Hypothyroidism typically leads to cold intolerance and dry skin⁶.

Choice A reason : Answering questions with nonsensical phrases is a positive symptom of schizophrenia. It reflects disorganized thinking and speech, which can manifest as incoherence or irrelevance in the patient's verbal communication². This symptom can significantly impair the patient's ability to engage in meaningful conversation and is often one of the more noticeable signs of schizophrenia during an assessment³.

Choice B reason : Seeing, hearing, or feeling something that is not really there, also known as hallucinations, are hallmark positive symptoms of schizophrenia. These sensory experiences occur without an external stimulus and can involve any of the senses, although auditory hallucinations are the most common in schizophrenia². Hallucinations can be extremely distressing for patients and can lead to difficulties in distinguishing reality from delusion³.

Choice C reason : The belief that personal significance is attached to trivial or unrelated external events, known as delusions of reference, is another positive symptom of schizophrenia. Patients may believe that messages are being sent to them through the television, radio, or other public means². This can lead to a profound sense of misunderstanding and isolation as the patient navigates a world they perceive as filled with hidden messages meant specifically for them³.

Choice D reason : While trouble staying on a schedule or finishing tasks can be associated with schizophrenia, it is not considered a positive symptom. These issues are more reflective of the negative symptoms of schizophrenia, which include avolition or the lack of motivation to initiate and complete goal-directed activities⁴.

Choice E reason : An inability to socially connect with others is also not a positive symptom but rather a negative symptom of schizophrenia. Negative symptoms represent a loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life⁴. Social withdrawal and impaired social interaction are common negative symptoms that can be mistaken for introversion or depression³.