Author Question: A client with residual schizophrenia, aged 60 years, spent 5 years in a state hospital before being ... (Read 162 times)

Kthamas · **on:** Jul 19, 2018

A client with residual schizophrenia, aged 60 years, spent 5 years in a state hospital before being
discharged to a community residence.

The client, who is now monitored by the community mental
health nurse, requires much encouragement to voice her needs and take independent action to get her
needs met. The nurse assesses this passive behavior as being the probable result of
a. dependency caused by institutionalizatio n.
b. cognitive deterioration from schizophrenia.
c. brain damage from recreational drug use.
d. neuroleptic drug side effects.

Question 2

In a rush of words, a client tells the community mental health nurse Everything's a mess I can't
concentrate. My disability check didn't come. My roommate moved out and the rent is too much for
me to pay on my own.

To top it all off, my therapist is moving out of state. I don't know where to
turn and I feel as though I'm coming apart at the seams.. A nursing diagnosis the nurse should
consider for this client is
a. decisional conflict related to challenges to personal values.
b. spiritual distress related to ethical implications of treatment regimen.
c. anxiety related to changes perceived as threatening to psychological equilibrium.
d. deficient knowledge related to need to solve multiple problems affecting security
needs.

kmb352 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

A
Institutionalizatio n brought about a decreased sense of self, resulting in lack of autonomy in many
clients. Clients became dependent on the hospital and its staff to meet their needs. When these
clients were discharged into the community many continued to demonstrate passive behaviors
despite efforts to rehabilitate them. Option B: Although the long-term effects of the disease process
may contribute to passivity, institutionalizatio n was probably a greater determinant of the behavior.
Option C: The scenario does not suggest recreational drug use. Option D: Neuroleptic drug side
effects would result in different behaviors.

Answer to Question 2

ANS: C
Subjective and objective data obtained by the nurse suggest the client is experiencing anxiety caused
by multiple threats to security needs. Option A: Data are not present to suggest decisional conflict,
ethical conflicts around treatment causing spiritual distress, or deficient knowledge.