A nurse is admitting a client with a new diagnosis of a personality disorder. Which of the following would make the nurse question this diagnosis? (Select all that apply.)
1. The client has been diagnosed with sickle cell anemia.
2. The client has an inflated self-appraisal and feels a sense of entitlement.
3. The client has a history of a substance use disorder.
4. The client is odd and eccentric but not delusional.
5. The client has an intellectual developmental disorder.
1, 3, 5
Rationale: The DSM-5 states that impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or sociocultural environment. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma). The nurse would question the diagnosis of a personality disorder in a client with sickle cell anemia, substance use disorder, or an intellectual developmental disorder.
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