A nurse is teaching a group of clients about the effects of various substances. Which of the following statements by a client indicates an understanding of the teaching?

A. "I hope I can prevent them from being hospitalized again.": While this shows concern, it suggests that the client feels responsible for preventing hospitalization, which can be an unrealistic expectation and reflects potential caregiver burden rather than acceptance.
B. "I will do my best even though I feel tired all of the time.": This reflects exhaustion and a sense of being overwhelmed, but it does not necessarily indicate acceptance of the role change. The client may still be struggling with the emotional toll of caregiving.
C. "I would like to have information about support groups.": This statement indicates a proactive approach to managing the caregiving role, which suggests that the client is beginning to accept the changes and is seeking resources to help cope. It shows openness to support and adaptation to the role.
D. "It is hard to make time for my children and my family member.": This indicates that the client is struggling with balancing caregiving and family responsibilities, which suggests difficulty in fully accepting the new caregiving role.

Rationale for correct choices:

• Fingernail assessment: Broken fingernails can be a sign of a struggle, as the client may have tried to defend themselves during the assault. Such injuries are commonly seen in cases of sexual assault, where victims may attempt to resist or protect themselves.
• Diagnostic results: The positive urine drug screen for GHB is key as it is often used as a "date rape drug" due to its ability to cause sedation, memory loss, and impaired judgment. Its presence supports the possibility of the client being drugged as part of a sexual assault.

Rationale for incorrect choices:

• Blood pressure: Blood pressure readings are typically not indicative of sexual assault. While anxiety or trauma can affect blood pressure, this measurement alone does not provide information directly related to sexual assault. Her BP is also within normal range.
• Abdominal examination: Mild tenderness in the abdomen could be incidental or related to other causes but is not directly linked to the typical findings in a sexual assault case. Abdominal examination would generally not be the primary assessment for identifying sexual assault unless there was significant trauma or injury to the abdomen.
• Temperature: A normal temperature of 37°C (98.6°F) does not indicate anything specific to sexual assault. While fever may occur in cases of infection, it is not a defining characteristic of sexual assault and doesn't help in confirming the occurrence.