A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

A. A client requests extra blankets when the thermostat in the room indicates 25.6° C (78° F): This behavior does not necessarily indicate delirium. It could be a response to feeling cold or a preference for additional warmth. While it may warrant further assessment, it is not a classic manifestation of delirium.

B. A client wants to know the current time while there is a clock on the wall: Asking about the time does not specifically indicate delirium. The client may simply want confirmation or may not have noticed the clock on the wall. This behavior is more likely related to memory or orientation than delirium.

C. A client refuses to get out of bed and has no motivation to attend to daily hygiene: This behavior may be concerning and could indicate depression or another mental health issue, but it is not a classic manifestation of delirium. Delirium typically involves acute changes in mental status, including confusion, disorientation, and fluctuating levels of consciousness.

D. A client attempts to climb out of bed and repeatedly states she must get home: This behavior is indicative of delirium. Attempting to leave the bed or facility and expressing a strong desire to go home, especially when it is not feasible or safe to do so, is a classic manifestation of delirium. Delirium often involves confusion, agitation, and impaired judgment, leading the individual to act in ways that are out of character or irrational.

A. "You are being unreasonable, and I will not call your doctor at this hour."

This response may escalate the situation by invalidating the client's feelings and refusing to address their request. It fails to recognize the client's distress and could lead to increased agitation or frustration.

B. "I can't call a doctor in the middle of the night unless it's an emergency."

While it's true that non-urgent matters may be deferred until regular hours, this response comes across as dismissive and may exacerbate the client's distress. It does not validate the client's feelings or offer support.

C. "You must be very upset about something."

This response acknowledges the client's emotions and shows empathy. It opens the door for the client to express their concerns, allowing the nurse to assess the situation further and address any immediate needs. It also avoids dismissing the client's request outright and maintains a therapeutic relationship.

D. "Go back to your room, and I'll try to get in touch with your doctor."

This response instructs the client to return to their room without addressing their emotional state or concerns. It lacks empathy and fails to engage with the client's needs effectively.