The nurse is helping a 56-year-old homeless woman develop a plan for after discharge. Which of the following would be most appropriate to include?

Correct Answer: A

Rationale: The correct answer is A: Contacting the woman's daughter as a possible source of support after the client's discharge. This is the most appropriate choice because involving family members can provide emotional and practical support for the client. It is important to leverage existing relationships and support systems to enhance the client's post-discharge plan. Summary of other choices: B: Contacting the woman's parents may not be appropriate as the client's relationship with her parents is not specified and involving them without consent may not be beneficial. C: Providing resources in a three-ring binder is not as personal or tailored to the client's specific needs and may not address the emotional support aspect. D: Providing telephone numbers of health insurance companies is important but not as crucial as establishing a support system through family members.

Correct Answer: B

Rationale: The correct answer is B: Anhedonia. Anhedonia refers to the inability to experience pleasure or joy in activities that were previously enjoyable. In the scenario provided, the client's statement about not enjoying crossword puzzles anymore indicates a loss of pleasure, which is a key symptom of anhedonia commonly seen in depression. A: Dysthymic disorder is a type of chronic mood disorder characterized by persistently depressed mood. The client's symptoms do not meet the criteria for a diagnosis of dysthymic disorder based on the information provided. C: Delusion refers to a fixed false belief that is not based in reality. The client's statement does not involve any delusional beliefs, so this choice is incorrect. D: Psychosis involves a loss of contact with reality, often manifesting as hallucinations or delusions. The client's statement does not indicate a break from reality, so psychosis is not the correct choice.

Correct Answer: B

Rationale: The correct answer is B, "I find that hard to believe." This statement demonstrates the therapeutic communication technique of voicing doubt by expressing skepticism in a non-confrontational manner. It allows the client to further elaborate on their thoughts and feelings, fostering open communication and exploration of underlying issues. Choice A paraphrases the client's statement, choice C assumes the client's feelings, and choice D shifts the focus to finding a solution rather than exploring the client's perspective.

Correct Answer: D

Rationale: The correct answer is D: Fulfilling relationships. Patients with intense and unstable relationships, idealization, devaluation, and feelings of emptiness likely have traits of borderline personality disorder. Developing fulfilling relationships is crucial in managing this disorder. It helps improve emotional stability, self-esteem, and coping skills. Effective work, communication skills, and productive activities are important but may not directly address the core issues of relationship instability and emotional dysregulation seen in this patient population.

Correct Answer: B

Rationale: The correct answer is B: The diathesis-stress model. This model suggests that individuals have a predisposition (diathesis) towards a certain mental health condition, such as depression, and this predisposition interacts with environmental stressors to trigger the condition. Suicide can result from the combination of genetic vulnerability (diathesis) and stressful life events (stressors). Elevated serotonin levels (choice A) are more associated with mood disorders like depression, not directly linked to suicide. Outward aggression turned inward (choice C) is more related to internalizing behaviors like self-harm, but not necessarily suicide. A lack of perfectionism (choice D) is not a widely recognized factor in suicide risk. The diathesis-stress model provides a comprehensive explanation for the complex interplay of genetic and environmental factors leading to suicide.