A disheveled patient in the acute phase of major depressive disorder is withdrawn, has psychomotor retardation, and has not showered for several days. The nurse will

Correct Answer: D

Rationale: The correct answer is D because the patient is in the acute phase of major depressive disorder, showing withdrawal and psychomotor retardation. Approach with empathy and understanding is crucial. Bringing up the issue at a community meeting (A) may embarrass the patient. Telling the patient to bathe daily (B) may come off as insensitive. Making observations (C) may not lead to action. Assisting the patient with showering in a firm and neutral manner (D) is the most appropriate as it shows empathy, respect, and provides practical support.

Correct Answer: D

Rationale: The correct answer is D, a residential program. This option is the most appropriate for a patient with antisocial personality disorder and recurring substance abuse issues because it offers a structured and intensive environment for long-term treatment and monitoring. The patient can benefit from 24/7 supervision, therapy, and support to address underlying issues contributing to relapse. In contrast, A (1-week detox) is too short and doesn't address underlying psychological factors. B (outpatient therapy) may not provide enough support and monitoring for this patient. C (12-step program) can be helpful but may not offer the level of structure and supervision needed for someone with antisocial personality disorder. Therefore, D is the best choice for this specific case.

Correct Answer: D

Rationale: The correct answer is D because injecting heroin typically leads to drowsiness, constricted pupils, and slurred speech due to its depressant effects on the central nervous system. Heroin acts as a sedative, causing drowsiness and slowing down brain function. Constricted pupils, known as pinpoint pupils, are a common physical sign of heroin use. Slurred speech may occur due to the drug's impact on coordination and muscle control. Choices A, B, and C are incorrect: A: Anxiety, restlessness, paranoid delusions are more commonly associated with stimulant drugs like cocaine or amphetamines. B: Muscle aching, dilated pupils, tachycardia are more indicative of stimulant drug use rather than heroin. C: Heightened sexuality, insomnia, euphoria are effects more commonly seen with stimulant drugs or hallucinogens, not heroin.

Correct Answer: A

Rationale: The correct answer is A because it addresses the fundamental issue of recognizing the need for long-term treatment, which is crucial for sustained recovery. It indicates the patient's acceptance of their condition and willingness to seek further help. Option B focuses on coping mechanisms that may hinder progress. Option C addresses anger management, which is not the immediate priority after detox. Option D, while important, does not directly relate to the patient's readiness for ongoing treatment. Overall, choosing option A ensures the patient's commitment to continuing care and increasing their chances of successful recovery.

Correct Answer: C

Rationale: The correct answer is C because assessing the availability of means and lethality of the method is crucial in preventing suicide. This information helps determine the level of immediate risk and allows for interventions to restrict access to lethal means. It is a priority over the patient's financial and educational status (A) as these factors may not directly impact suicide risk. Patient's insight into suicidal motivation (B) is important but does not address the immediate risk. Quality and availability of social support (D) is significant but assessing means and lethality takes precedence in immediate risk assessment.