A client diagnosed with schizophrenia functions well during hospitalization but decompensates after discharge. What does the therapeutic milieu provide that may be missing in the home environment?

Mandated activities.

Visitor restrictions.

Structured programming.

Peer pressure.

Answer and Explanation

The Correct Answer is C

Choice A reason:
Mandated activities are part of a therapeutic milieu, but they are not the primary element that contributes to the stability of a client with schizophrenia. While these activities provide a routine, they do not encompass the comprehensive support system that structured programming offers.

Choice B reason:
Visitor restrictions can be a component of a therapeutic milieu, particularly in inpatient settings, to ensure a safe and controlled environment. However, this is not typically what is missing in the home environment that leads to decompensation.

Choice C reason:
Structured programming is a key element of the therapeutic milieu that provides a stable and predictable environment, which is often lacking at home. This structure includes scheduled therapy sessions, social interactions, and activities that are designed to improve coping skills and social functioning. The consistency and predictability of structured programming can significantly benefit individuals with schizophrenia, helping them maintain functional stability.

Choice D reason:
Peer pressure is not a therapeutic aspect of the milieu. In fact, peer pressure can sometimes be negative. However, positive peer interactions and support are important in a therapeutic setting, as they can provide encouragement and a sense of community.

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Correct Answer is D

Explanation

Choice A reason:
Dysuria, or painful urination, is a common symptom of cystitis and indicates inflammation of the bladder, often caused by a urinary tract infection (UTI). While it is a symptom to monitor, it does not necessarily indicate progression of the infection.

Choice B reason:
An increased frequency of urination can be a symptom of cystitis due to irritation of the bladder lining. However, like dysuria, it is a common symptom of a UTI and may not signify that the infection is worsening.

Choice C reason:
Pyuria, the presence of white blood cells in the urine, and hematuria, the presence of blood in the urine, are both indicators of inflammation and infection. These symptoms can occur with cystitis but are also not specific to the progression of the infection.

Choice D reason:
Fever is a systemic response to infection and can indicate that a UTI, such as cystitis, is worsening or spreading, possibly to the kidneys, which is known as pyelonephritis. Monitoring for fever is important because it may necessitate more aggressive treatment, such as antibiotics, and possibly hospitalization if the infection is severe.

A. Respiratory rate of 24/min. B. Weak, nonproductive cough. C. Pulse oximetry (SpO2) of 90%. D. Shortness of breath with activity.

Correct Answer is B

Explanation

Choice A reason:
A respiratory rate of 24/min is slightly elevated, which can be expected in a client with pneumonia due to the body's attempt to increase oxygen intake and carbon dioxide elimination. However, this rate does not directly indicate ineffective airway clearance.

Choice B reason:
A weak, nonproductive cough is a key indicator of ineffective airway clearance. In pneumonia, the presence of secretions in the airways is common, and an effective cough is necessary to clear these secretions. A weak cough that does not produce sputum suggests that the client is unable to clear their airways effectively, which can lead to impaired gas exchange and worsening of symptoms.

Choice C reason:
Pulse oximetry (SpO2) of 90% indicates that the client's oxygen saturation is below the normal range, which is typically between 95-100% for healthy individuals. While this finding is concerning and warrants intervention, it is a result of ineffective airway clearance rather than a direct indicator of it.

Choice D reason:
Shortness of breath with activity is common in clients with pneumonia and can result from various factors, including impaired gas exchange, decreased lung compliance, and increased work of breathing. While it may be associated with ineffective airway clearance, it is not as specific as a weak, nonproductive cough for indicating this particular problem.

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A client diagnosed with schizophrenia functions well during hospitalization but decompensates after discharge. What does the therapeutic milieu provide that may be missing in the home environment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has had repeated instances of cystitis. When considering the possible progression of the infection, for which symptoms should the client be taught to monitor?

Correct Answer is D

Explanation

A nurse formulates the problem of ineffective airway clearance for a client who has pneumonia. Which assessment data best supports this problem?

Correct Answer is B

Explanation

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