A nurse is caring for an adolescent who is experiencing depression. Which of the following findings should the nurse expect? (Select all that apply.)

Findings Consistent with Antisocial Personality Disorder (ASPD)

1. Experience with the legal system since teenage years: Individuals with ASPD often exhibit a pattern of behavior that violates societal norms and legal codes, leading to frequent encounters with the legal system. The client has a history of criminal behavior, including shoplifting, auto theft, and resisting arrest, which aligns with the diagnostic criteria for ASPD.

2. Substance use: Substance abuse is common among individuals with ASPD. The client's history of driving under the influence of alcohol and possession and sale of marijuana demonstrates a disregard for the law and social norms, which is characteristic of ASPD.

3. Acceptance of responsibility: A key feature of ASPD is a lack of remorse or responsibility for one’s actions. The client’s statement, "That car wreck was not my fault! That judge just has it out for me," indicates a refusal to accept responsibility for their actions and a tendency to blame others, which is consistent with ASPD.

4. Relationship with family: Estrangement from family members is often seen in individuals with ASPD due to their manipulative, deceitful, or exploitative behavior, which can damage personal relationships. The client's estrangement from their family supports this pattern of unstable and problematic relationships.

Findings Not Consistent with ASPD

5. Adhering to financial responsibilities: The client does not adhere to financial responsibilities, as evidenced by their eviction for failure to pay rent. This behavior is consistent with ASPD, where individuals often exhibit irresponsibility, particularly in financial matters.

6. Employment status: Employment status alone is not a definitive indicator of ASPD. While the client is currently employed by a food delivery service, which suggests some level of functional ability, it does not provide enough context regarding their overall adherence to social norms or work behavior.

7. Compassion toward others: The client displays a lack of compassion toward others, which is a hallmark of ASPD. They refer to other clients in a derogatory manner ("losers") and show disdain for their feelings. This behavior reflects the lack of empathy and disregard for others typical in ASPD.

8. Rechanneling anger with physical activity: While engaging in physical activity to manage anger is generally a positive coping strategy, it does not specifically relate to the diagnostic criteria for ASPD. The client's use of physical activity to mitigate anger does not negate the presence of other antisocial traits.

A. Reprimand the client about the potential damage that has occurred due to overexercising her body. Reprimanding the client is not therapeutic and can increase feelings of guilt or shame, potentially exacerbating the condition. A more supportive and understanding approach is needed to address the behavior. Therefore, this choice is incorrect.

B. Praise the client for looking at herself in a mirror. Praising the client for looking at herself in the mirror is not specifically relevant to managing the overexerting behavior and does not address the core issues of anorexia nervosa. It may also reinforce body image concerns. Therefore, this choice is incorrect.

C. Restrict the client from being weighed. Weighing restrictions are common in the treatment of anorexia nervosa to reduce anxiety around weight gain. However, this action alone does not directly address the overexercising behavior. Instead, comprehensive behavioral and therapeutic strategies should be employed. Therefore, this choice is incorrect.

D. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise. Encouraging the client to discuss her urges to exercise with a nurse provides an opportunity for therapeutic intervention and support. It helps in addressing the behavior in a constructive manner and provides a means for the client to seek help when struggling with their impulses. This choice is correct.