The nurse is assisting in the care of a client in an inpatient mental health facility. Click to highlight the statements in the nurses' notes that indicate that the client is progressing as expected. To deselect a finding, click on the finding again. Nurses' Notes Day 14, 0800: Client denies that substance use was triggered by any childhood trauma. Client states that they "just got in with the wrong set of friends." Client has identified several coping mechanisms when they feel tempted to use the substances. Client is not sure where they will live after discharge. Client states that they are looking forward to seeing old friends when they are released from the hospital. Client states that they have a plan to receive their methadone daily following discharge. The client has written a plan for what to do if relapse should occur. Client states that they are willing to participate in outpatient therapy following discharge.

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.