A nurse is reinforcing education to a newly licensed nurse about comorbidities associated with cluster B personality disorders. The nurse should identify which of the following disorders as a comorbidity?

A. Lithium toxicity. The AIMS test does not assess lithium toxicity. Lithium toxicity is monitored through serum lithium levels and clinical symptoms such as tremors, nausea, confusion, and ataxia. Severe toxicity can lead to seizures, coma, and organ failure, requiring immediate intervention.
B. Alcohol withdrawal. The AIMS test does not assess alcohol withdrawal. Withdrawal symptoms include tremors, hallucinations, seizures, and autonomic instability. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) is commonly used to assess symptom severity and guide treatment.
C. Tardive dyskinesia. The AIMS test is used to assess tardive dyskinesia, a movement disorder caused by long-term antipsychotic use. It evaluates involuntary movements of the face, tongue, and extremities, helping clinicians monitor progression and adjust medications to minimize symptoms.
D. Opiate withdrawal. The AIMS test does not assess opiate withdrawal. Symptoms include sweating, agitation, diarrhea, and muscle aches. The Clinical Opiate Withdrawal Scale (COWS) is typically used to assess withdrawal severity and guide opioid detoxification or replacement therapy.

A. Splitting is a defense mechanism commonly used by clients with borderline personality disorder. It involves viewing people or situations as entirely good or entirely bad, leading to rapidly shifting opinions and emotional reactions. This black-and-white thinking can create division among healthcare providers, as the client may idealize one staff member while devaluing another, causing conflict within the team.
B. Reaction formation occurs when a person expresses the opposite of their true feelings, often due to discomfort with their actual emotions. While seen in some personality disorders, it is not a hallmark feature of borderline personality disorder and does not typically contribute to team division.
C. Denial involves refusing to acknowledge reality or facts that cause distress. Though common in various mental health conditions, it does not specifically create division among healthcare providers in the way splitting does. Clients with borderline personality disorder may use denial, but it is not their primary defense mechanism.
D. Regression is a defense mechanism where an individual reverts to earlier developmental behaviors in response to stress. While it can be seen in borderline personality disorder, it does not typically lead to splitting within the healthcare team, as it primarily affects the client’s own coping mechanisms rather than interpersonal dynamics.