A nurse in a substance treatment facility is contributing to the plan of care for a newly admitted client. Which of the following interventions should the nurse recommend? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)

A. "I'm uncomfortable when people tell sexually explicit jokes.": Discomfort with sexually explicit jokes reflects personal boundaries and social comfort, but it does not indicate a concern about the client’s own sexuality or sexual function.

B. "I feel like my ability to perform sexually has changed since I've gotten older.": This statement directly expresses a concern about sexual function and performance, indicating the client may be experiencing changes in libido, arousal, or sexual satisfaction. It signals the need for assessment and counseling regarding sexual health.

C. "I have the same level of sexual desire for my partner as I did in the past.": Maintaining sexual desire suggests that the client does not have current concerns about sexuality. It reflects stability in sexual function rather than a problem or worry.

D. "I've been with the same sexual partner for 13 years.": Duration of a relationship provides context about the client’s sexual history but does not indicate a current concern regarding sexuality. It is descriptive rather than indicative of distress or issues.

Rationale for correct choices

• Client has identified several coping mechanisms when they feel tempted to use the substances: Developing coping strategies is a key indicator of progress in substance use disorder treatment. It shows the client is gaining insight into triggers and is preparing practical approaches to manage cravings, reducing the likelihood of relapse.

• Client states that they have a plan to receive their methadone daily following discharge: Adherence to medication-assisted therapy like methadone demonstrates the client is engaging in ongoing treatment, which supports sustained recovery and helps prevent withdrawal symptoms or relapse.

• The client has written a plan for what to do if relapse should occur: Creating a relapse prevention plan reflects proactive problem-solving and understanding of recovery challenges. It indicates the client is taking responsibility for their own care and preparing for potential setbacks, which is expected progress.

• Client states that they are willing to participate in outpatient therapy following discharge: Willingness to continue therapy after discharge demonstrates commitment to long-term recovery. Engagement in structured follow-up is a positive outcome and reflects the client’s motivation to maintain sobriety.

Rationale for Incorrect choices

• Client denies that substance use was triggered by any childhood trauma: While the client’s perception is noted, this statement does not directly reflect progress in coping, treatment adherence, or relapse prevention. It is informational but does not indicate measurable advancement in recovery goals.

• Client states that they are looking forward to seeing old friends when they are released from the hospital: Anticipating contact with old friends may pose a risk of relapse if these friends are associated with substance use. This statement may indicate potential triggers rather than expected improvement.