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The nurse manager is responsible for administrative oversight, staffing, and unit operations. While they may be informed of serious events, they are not the immediate clinical authority to address suspected lithium toxicity. Lithium toxicity is a medical emergency requiring physician intervention, not administrative management.

The psychiatric nurse is skilled in monitoring mental health symptoms and providing therapeutic interventions. However, the psychiatric nurse does not have the authority to prescribe or adjust medications. While they can support the client and report findings, they cannot directly intervene in the pharmacological management of lithium toxicity.

The recreation therapist focuses on promoting psychosocial well-being through activities and leisure interventions. They do not have the medical expertise or authority to manage medication toxicity. Notifying them would not address the urgent clinical need of suspected lithium toxicity.

Dependent personality disorder is characterized by excessive reliance on others for emotional support and decision-making. These individuals fear abandonment and struggle with self-confidence. While dependency is a hallmark, mistrust and suspicion are not features of this disorder, making it incorrect in this context.

Schizoid personality disorder involves detachment from social relationships and a limited range of emotional expression. Individuals with this disorder prefer solitary activities and show little interest in forming close relationships. Although they are socially withdrawn, they are not typically suspicious or mistrustful of others, so this does not match the question.

Histrionic personality disorder is marked by excessive emotionality and attention-seeking behavior. Individuals often display dramatic, theatrical expressions and seek approval from others. Suspiciousness and pervasive mistrust are not characteristics of this disorder, making it an incorrect choice.

Insisting that others follow rules is more characteristic of obsessive-compulsive personality disorder, where individuals are preoccupied with orderliness, rules, and control. This does not align with the dramatic, attention-seeking behaviors of histrionic personality disorder.

Wondering why others are friendly is more aligned with paranoid personality disorder, where individuals misinterpret others’ motives and are suspicious of kindness. This is not typical of histrionic personality disorder.

Relying on others to make decisions is characteristic of dependent personality disorder, where individuals fear abandonment and lack confidence in their own judgment. This is not a defining feature of histrionic personality disorder.

This response shifts the focus to recovery but does not directly enforce the rule. Clients with antisocial personality disorder often manipulate situations, so vague reasoning may invite further argument.

This response places responsibility on the supervisor rather than the nurse’s authority. It can encourage manipulation by making the nurse appear powerless.

Allowing the client to break the rule “just this once” reinforces manipulative behavior and undermines consistency. It teaches the client that rules can be bent through persuasion, which is counterproductive.

While updating treatment plans is important, it is not the primary reason for frequent team meetings in this context. The main issue is manipulation, not treatment updates.

Informing rotating staff is helpful, but again, the central concern is manipulation. Consistency across all staff members is more critical than simply updating new staff.

Processing staff frustrations is valuable for team morale, but it is not the main reason for meetings. The priority is preventing manipulation through consistent approaches.

This response is too blunt and may feel rejecting to the client, which can trigger abandonment fears common in borderline personality disorder.

This response explores feelings but risks reinforcing dependency on the nurse by focusing on the client’s perception of being misunderstood.

While supportive, this response may encourage idealization of the nurse, which is common in borderline personality disorder. It does not set appropriate boundaries.

Using “I” statements is an assertiveness training technique, which helps communication but is not specifically cognitive restructuring.

Saying “stop” to negative thoughts is a thought-stopping technique, which is related but not the same as restructuring. It interrupts thoughts but does not replace them with realistic alternatives.

Replacing negative thoughts with positive ones is closer to positive self-talk. While helpful, it does not fully address the restructuring process of evaluating and reframing distorted cognitions.

Crying loudly when requests are denied is more consistent with histrionic personality disorder, where individuals display exaggerated emotional responses to gain attention. It does not reflect the core features of avoidant personality disorder.

Showing no remorse after harming another person’s property is characteristic of antisocial personality disorder, where disregard for others’ rights and lack of guilt are common. This is not aligned with avoidant personality disorder.

Multiple failed marriages may be associated with borderline personality disorder due to unstable relationships and fear of abandonment. It is not a defining feature of avoidant personality disorder.

Regular assessments are important for monitoring progress, but they do not directly facilitate behavioral change. They are supportive measures rather than the primary driver of success.

Educating the client about compliance is helpful, but compliance alone does not ensure behavioral change. Without active collaboration, education may feel directive and fail to address the client’s underlying resistance.

Understanding the etiology of medications is useful for knowledge, but it does not directly influence behavioral change. Personality disorders require psychosocial interventions more than pharmacological explanations.

Glucocorticoid activity is related to stress response and the hypothalamic-pituitary-adrenal axis. While abnormalities here can contribute to depression, decreased glucocorticoid activity is not the primary neurochemical imbalance associated with depression.

Increased dopamine activity is more commonly linked to conditions such as schizophrenia or mania. Depression is typically associated with reduced neurotransmitter activity, not increased dopamine.

The kindling process refers to repeated stimulation of neural pathways that can lower the threshold for mood episodes, particularly in bipolar disorder. While it may play a role in mood disorders, it is not the primary explanation for depression’s neurochemical imbalance.