A nurse is reviewing a client's medication list. Which medication has been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease?

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. "Age-related cognitive changes may lead to alterations in mental status." Age-related cognitive changes, such as mild cognitive impairment, can increase the risk of delirium, but the statement is too general. Delirium is typically acute and caused by specific factors like medication, infection, or metabolic imbalances, not just normal age-related changes . Therefore, this choice is incorrect.

B. "Lack of rigorous exercise may lead to alterations in mental status." While lack of exercise can impact overall health and well-being, it is not a direct risk factor for delirium. Delirium is more closely associated with acute medical conditions, medication interactions, or environmental factors . Therefore, this choice is incorrect.

C. "Decreased social interaction may lead to profound isolation and psychosis." Decreased social interaction can lead to isolation and mental health issues like depression, but it is not a direct cause of delirium. Delirium typically results from acute physiological changes rather than social factors . Therefore, this choice is incorrect.

D. "Taking multiple medications may lead to adverse interactions or toxicity." Polypharmacy, or taking multiple medications, is a significant risk factor for delirium in older adults due to the potential for adverse drug interactions and toxicity. This can lead to acute changes in mental status characteristic of delirium . This choice is correct.