A nurse is screening children and adolescents for exposure to adverse childhood experiences (ACEs). Which of the following clients is considered to have experienced an ACE?

Choice A rationale
Families that are isolated from other people, such as extended family, friends, and neighbors, are not typically considered a protective factor against adverse childhood experiences. Social isolation can actually increase the risk of mental health issues, as it can lead to feelings of loneliness and lack of social support.
Choice B rationale
Families where caregivers have college degrees or higher can often provide a more stable environment, both emotionally and financially. Higher levels of education are often linked to

better understanding of child development and more effective parenting strategies. Additionally, higher education is often associated with higher income, which can reduce stressors related to financial instability.
Choice C rationale
Families that include young caregivers or single parents can face additional stressors, such as financial strain and lack of social support, which can increase the risk of adverse childhood experiences. Therefore, this is not typically considered a protective factor.
Choice D rationale
Children who don’t feel close to their guardians and don’t feel loved are at a higher risk of developing mental health disorders. Feeling unloved and uncared for can lead to feelings of insecurity, low self-esteem, and difficulty forming healthy relationships later in life.

Choice A rationale
The statement that the milieu consists of the physical and psychosocial environmental factors indicates an understanding of therapeutic milieu. The therapeutic milieu refers to the structured and safe environment that is created in a mental health setting to promote therapeutic interaction and healing.
Choice B rationale
The positioning of chairs around the perimeter of the day room does not necessarily indicate an understanding of therapeutic milieu. While the physical arrangement of the environment can contribute to the therapeutic milieu, it is not the defining aspect.
Choice C rationale
The statement that therapeutic milieu requires unstructured programming, allowing clients to focus on their interests, does not accurately reflect the concept of therapeutic milieu. While client interests are important, therapeutic milieu often involves structured activities designed to promote therapeutic interaction and healing.
Choice D rationale
The statement that clients can keep any personal items in their rooms does not necessarily indicate an understanding of therapeutic milieu. While personal items can contribute to a sense of comfort and safety, therapeutic milieu involves more than just the physical environment.