A client receives a court order for commitment. Which concept exemplifies a “least restrictive environment”?

Admission of client to a locked inpatient psychiatric unit

Placement of client in a secured padded room in response to threats of self-harm

Involuntary commitment to an outpatient community mental health center

Medication administration for sedation so the client cannot get out of bed

Answer and Explanation

The Correct Answer is C

Choice A reason:
Admission to a locked inpatient psychiatric unit is a more restrictive environment. While necessary for some clients, it limits their freedom and autonomy. The least restrictive environment principle seeks to avoid such settings unless absolutely necessary.

Choice B reason:
Placement in a secured padded room is highly restrictive and typically used only in extreme cases where the client poses an immediate danger to themselves or others. This setting is far from the least restrictive environment.

Choice C reason:
Involuntary commitment to an outpatient community mental health center represents a less restrictive environment. It allows the client to receive necessary treatment and support while remaining in the community, maintaining a higher level of independence and normalcy.

Choice D reason:
Medication administration for sedation to the point where the client cannot get out of bed is a highly restrictive intervention. It significantly limits the client’s autonomy and is not aligned with the principle of providing care in the least restrictive environment.

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Correct Answer is D

Explanation

Choice A reason:

“A relapse plan describes how you use coping strategies for living in the community.” While this is partially true, it does not fully capture the purpose of a relapse plan. A relapse plan is more comprehensive and includes recognizing early warning signs and taking specific actions to prevent a full relapse.

Choice B reason:

“A relapse plan addresses your living, housing, and working needs.” This statement is not accurate. A relapse plan focuses on managing symptoms and preventing relapse rather than addressing broader social needs like housing and employment.

Choice C reason:

“A relapse plan explains how you can be hospitalized if needed.” While hospitalization may be part of a relapse plan, the primary focus is on recognizing early symptoms and taking steps to manage them before hospitalization becomes necessary.

Choice D reason:

“A relapse plan helps your recovery by recognizing symptoms of schizophrenia and provides steps to follow if symptoms are getting worse.” This statement accurately reflects the purpose of a relapse plan. It emphasizes the importance of early recognition and proactive management of symptoms to support the client’s recovery.

A. Anger and aggressiveness directed toward others B. Fearfulness regarding treatment measures C. Willingness to participate in the planning of the care and treatment plan D. An understanding of the pathology and symptoms of the diagnosis

Correct Answer is C

Explanation

Choice A reason:
Anger and aggressiveness directed toward others are not typically associated with voluntary admission. Clients who voluntarily seek treatment are usually motivated to improve their condition and are less likely to exhibit aggressive behaviors towards others. Aggressiveness may be more common in involuntary admissions where the client feels coerced.

Choice B reason:
Fearfulness regarding treatment measures can occur in any client, regardless of whether the admission is voluntary or involuntary. However, clients who voluntarily admit themselves are generally more open to treatment and less likely to exhibit significant fearfulness about the treatment process.

Choice C reason:
Willingness to participate in the planning of the care and treatment plan is a common behavior in clients who have voluntarily admitted themselves. These clients are typically motivated to engage in their treatment and collaborate with healthcare providers to achieve their health goals. Voluntary admission often indicates a proactive approach to managing their condition.

Choice D reason:
An understanding of the pathology and symptoms of the diagnosis is not necessarily linked to the nature of the admission. While some clients may have a good understanding of their condition, others may not, regardless of whether their admission was voluntary or involuntary. Education about the diagnosis is an important part of the treatment process for all clients.

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A client receives a court order for commitment. Which concept exemplifies a “least restrictive environment”?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to discharge a client who has been diagnosed with schizophrenia. The client asks, “I am not sure why I need to have a relapse plan.” Which of the following responses should the nurse make?

Correct Answer is D

Explanation

On review of the client’s record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care anticipating which client behavior?

Correct Answer is C

Explanation

A nurse is interviewing a client who is experiencing negative symptoms of psychosis about their family history of schizophrenia. In which of the following phases of the nursing process should this take place?

A nurse is caring for a client who is experiencing a crisis related to anxiety. Which of the following actions should the nurse take? (Select all that apply).

A nurse is explaining advance care directives, or “living wills,” to a client and the client’s spouse. Which detail would the nurse include in the description of an advance care directive?

A nurse is reviewing the DSM-5 diagnostic criteria for schizophrenia. Which of the following symptoms must be present for a client to be diagnosed with schizophrenia? (Select all that apply.)

A nurse is planning care for a client who has paranoid schizophrenia. Which of the following interventions should be included in the plan of care?

While working with an older client, a nurse begins to think of the client as a grandparent and responds to the client as a grandchild. The nurse is developing what type of emotional reaction?

The nurse calls security and has physical restraints applied to a client who was admitted voluntarily when the client becomes verbally abusive, demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions?

A nurse is providing education to a group of staff members about schizophrenia. Which of the following age groups should the nurse include as the age when schizophrenia is typically diagnosed?