A patient diagnosed with an antisocial personality disorder was treated several times for substance abuse, but each time the patient relapsed. Which treatment approach is most appropriate?

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: 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.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): 1. Genetics play a significant role in suicide risk, as studies have shown a hereditary component. 2. Identical twins share 100% of their genes, making the other twin more vulnerable. 3. Monitoring and support can help identify warning signs and provide necessary interventions. 4. Proactive measures can reduce the risk of suicide in the remaining twin. Summary of Incorrect Choices: B: Apathy is not the primary cause of suicide, and motivation alone is not a comprehensive solution. C: Identifying with a suicide victim may increase the risk of suicidal behavior in the other twin. D: Fraternal twins share only 50% of their genes, so they do not have the same high genetic risk as identical twins.

Correct Answer: D

Rationale: The correct answer is D: Risk for other-directed violence. Priority is given to the safety of the patient and others. The patient's history of past violent behavior, including breaking windows and torturing animals, suggests a propensity for violence. This places the patient and others at risk of harm. Option A (Risk for injury) is not as appropriate as it focuses on the patient's risk of self-harm rather than harming others. Option B (Ineffective coping) may be a contributing factor, but the immediate concern is the risk of violence. Option C (Impaired social interaction) does not address the potential for harm. Therefore, prioritizing the diagnosis of Risk for other-directed violence is crucial in ensuring the safety of all involved.