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 ["A","B","D","E"]

Explanation

Choice a reason:
Assessing capillary refill and the color of the extremity is essential for determining the vascular status of the limb. A normal capillary refill time is less than 2 seconds and indicates good blood flow. The color should be consistent with the rest of the body, without pallor or cyanosis, which could indicate compromised circulation.

Choice b reason:
Checking pedal pulses is another critical aspect of assessing vascular integrity. The presence of strong and equal pulses in both feet suggests that the blood supply to the lower extremities is not compromised.

Choice c reason:
While the ACE wrap and Velcro boot are part of the postoperative management to provide support and protection to the affected limb, and hanging weights might be used for traction, these are not part of the physiological assessment of the extremity.

Choice d reason:
Monitoring pin sites for signs of infection, such as redness, swelling, or discharge, is crucial in a client with ORIF. Infection can lead to complications that may affect the healing process and the integrity of the fixation.

Choice e reason:
Evaluating the temperature, sensation, and movement of toes helps in assessing for potential nerve damage or compartment syndrome. Any changes in these parameters should be reported immediately as they may signify serious complications.

A. Provide bright lighting and check on the client's mental status hourly. B. Keep the lights dim and keep a radio on continuously. C. Have the client sit by the nurse's desk while awake and provide rest periods in a room with the television on. D. Provide a well-lit room without glare or shadows and limit noise.

Correct Answer is D

Explanation

Choice A Reason:
Bright lighting can be overwhelming for clients experiencing perceptual alterations. While regular checks on the client's mental status are important, excessive brightness can exacerbate sensory overload. The goal is to create an environment that is calming and reduces sensory stimuli to manageable levels.

Choice B Reason:
Keeping the lights dim may help to soothe some clients, but continuous noise from a radio can contribute to sensory overload. It's crucial to tailor the environment to the individual needs of the client, which often means providing a quiet space with minimal auditory distractions.

Choice C Reason:
Having the client sit by the nurse's desk may provide necessary supervision, but it can also expose the client to high levels of activity and noise, which can be disorienting. Rest periods with the television on can be distracting and may not offer the tranquil environment needed for a client with perceptual alterations.

Choice D Reason:
Providing a well-lit room without glare or shadows and limiting noise is the most appropriate environmental change for a client with perceptual alterations. This approach helps to reduce the risk of misperceptions and hallucinations, which can be triggered by shadows and glare. A quiet and well-lit environment supports better sensory processing and helps to maintain orientation.

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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

The nurse is caring for a client who sustained a compound fracture of the right tibia/fibula postoperative ORIF (open reduction internal fixation). A complete assessment of the affected extremity would include:

Correct Answer is ["A","B","D","E"]

Explanation

What environmental changes should the nurse make for a client who is experiencing perceptual alterations?

Correct Answer is D

Explanation

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?

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