When teaching the family of a client with chronic mental illness about the primary cause of relapse and rehospitalization, the nurse would indicate which of the following is the primary factor?

A. Non-adherence to medications: Antipsychotic medications are essential for symptom control, and missing doses or discontinuing treatment often leads to exacerbation of psychotic symptoms and the need for hospitalization.

B. Non-attendance of treatment programs: While skipping therapy or support groups can negatively affect progress, it is not the main cause of relapse. Medication adherence remains the most critical component in preventing symptom recurrence and maintaining stability.

C. Lack of social activities: Social isolation can worsen negative symptoms and impact overall quality of life, but it does not directly cause acute relapse requiring hospitalization. The client may remain stable on medications even with limited social interactions.

D. Substance use to self medicate: Substance use can complicate treatment and increase relapse risk, but it is not the primary factor. Even clients without substance use issues frequently relapse if they stop taking prescribed antipsychotics.

A. High-calorie, high-protein diet: Increased work of breathing elevates caloric needs, and protein supports respiratory muscle strength and tissue repair. Adequate calories and protein help prevent weight loss and muscle wasting.

B. Bland, soft diet: While easier to chew, a bland soft diet does not specifically meet the increased nutritional needs of COPD clients. It may be helpful in other conditions but is not the best choice here.

C. Low-fat, low-cholesterol diet: Although heart-healthy, this diet does not address the elevated energy and protein demands of COPD. Restricting fat unnecessarily can limit caloric intake, worsening malnutrition in these clients.

D. Low-sodium, high-calorie diet: Sodium restriction is more critical for conditions like hypertension or heart failure. In COPD, the emphasis should be on high-calorie and high-protein intake rather than sodium control unless comorbidities require it.