A nurse is providing counseling to a client who has substance use disorder.

Exhibits

The nurse is discussing the client's concerns regarding relapse. Which of the following client statements indicates the client is adhering to the relapse prevention plan? (Select all that apply)

A. SSRIs are more effective in relieving manifestations. Both SSRIs and TCAs are effective in treating depression, but SSRIs are often preferred due to their more favorable side effect profile. TCAs may actually be more effective for some individuals, especially in severe depression, but their side effects limit their widespread use. SSRIs are not necessarily more effective in all cases.
B. SSRIs produce a more sedative effect. SSRIs generally do not have strong sedative properties. In contrast, TCAs often cause significant sedation due to their antihistaminic effects. Some SSRIs, like fluvoxamine and paroxetine, can cause mild drowsiness, but overall, TCAs are more sedating.
C. TCAs are lethal in overdose. TCAs pose a significant risk in overdose due to their cardiotoxic effects, including arrhythmias, hypotension, and seizures. Even small amounts beyond the therapeutic range can cause fatal outcomes. This is a major reason why SSRIs are preferred in individuals at risk for suicide.
D. TCAs have fewer cardiovascular effects. TCAs have more pronounced cardiovascular side effects, including orthostatic hypotension, tachycardia, and QT prolongation, due to their effects on alpha-adrenergic and sodium channels. In contrast, SSRIs have minimal cardiovascular impact, making them safer for clients with heart conditions.

A. A client who has a new diagnosis of major depressive disorder. A new diagnosis of major depressive disorder (MDD) can often be managed through outpatient therapy and medication. Assertive Community Treatment (ACT) is typically reserved for individuals with severe, persistent mental illness, particularly those with frequent hospitalizations or difficulty adhering to treatment.
B. A client who has repeated acute care admissions due to schizophrenia. ACT is a specialized, intensive, community-based intervention designed for individuals with severe mental illness, such as schizophrenia, who have difficulty maintaining stability in the community. This model provides continuous, comprehensive care to reduce hospitalizations and improve quality of life.
C. A client who has requested family therapy following the death of a family member. Family therapy is beneficial for grief counseling, but it does not require ACT services. ACT focuses on individuals with chronic psychiatric disorders who need multidisciplinary, long-term support.
D. A client who has physical injuries following an incident of partner violence. Survivors of intimate partner violence may require medical care, counseling, and support services, but ACT is not the appropriate intervention. Instead, referrals to domestic violence shelters, crisis counseling, or legal assistance may be more suitable.