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?

B. Ability to perform calculations: Assessing the client's ability to perform calculations helps in evaluating cognitive functioning. Impairments in calculation abilities can indicate cognitive decline associated with dementia. Tasks such as simple arithmetic or counting backward can be included in the assessment.

C. Long-term memory: Evaluating long-term memory is essential as it helps assess the client's ability to recall events, experiences, and information from the distant past. Long-term memory deficits are often seen in various types of dementia, and assessing this aspect provides valuable information about the extent of cognitive impairment.

D. Level of orientation: Assessing the client's level of orientation to time (e.g., awareness of date, day, season), place (e.g., awareness of current location), and person (e.g., awareness of self and others) is crucial in evaluating cognitive function. Orientation deficits are common in dementia and can provide insights into the progression and severity of the condition.

E. Recall ability: Evaluating the client's ability to recall recent events, information, or instructions assesses short-term memory function, which is often impaired in dementia. Tasks such as asking the client to repeat a series of words or recall recent activities help in assessing recall ability and memory impairment associated with dementia.

C. Dialectical behavior therapy (DBT):

Rationale: This is the correct intervention. Dialectical behavior therapy (DBT) is a type of psychotherapy that is specifically designed to treat borderline personality disorder (BPD). It focuses on teaching clients skills to manage their emotions, improve relationships, and cope with distressing situations effectively. Including DBT in the discharge plan for a client with BPD can help them continue their therapeutic progress after leaving the hospital or clinical setting.

Incorrect:

A. Safety plan:

Rationale: While a safety plan may be appropriate for some clients with borderline personality disorder, it is not specific to DBT and may not address the broader range of issues that DBT aims to target. Safety plans typically focus on identifying triggers for self-harm or suicidal ideation and outlining steps for managing crises, whereas DBT encompasses a more comprehensive approach to managing emotions and behaviors.

B. Behavioral contract:

Rationale: Behavioral contracts are agreements between individuals and their treatment providers that outline specific behaviors, consequences, and rewards. While behavioral contracts may be used as part of a comprehensive treatment plan for clients with BPD, they do not specifically address the skills-based approach of DBT.

D. Bibliotherapy:

Rationale: Bibliotherapy involves the use of written materials, such as self-help books or educational resources, to support therapeutic goals. While reading materials may complement DBT and other therapeutic approaches, bibliotherapy alone is not considered a primary intervention for treating borderline personality disorder.