Clinical pathways are used in managed care settings to

Correct Answer: D

Rationale: The correct answer is D. Clinical pathways in managed care settings aim to streamline the care process and reduce costs by standardizing care, improving efficiency, and promoting evidence-based practices. This helps in achieving better outcomes and cost-effective care delivery. A, B, and C are incorrect because clinical pathways do not specifically focus on stabilizing aggressive patients, identifying obstacles to care, or relieving nurses of planning responsibilities. These functions may be part of the overall care process but are not the primary purpose of implementing clinical pathways in managed care settings.

Correct Answer: B

Rationale: The correct answer is B because lethargy and confusion in a client with gastroenteritis may indicate dehydration or electrolyte imbalance, which can lead to serious complications. The nurse should report this finding first to prevent deterioration. Choice A is incorrect because thick productive cough and thirst in a client with cystic fibrosis are common symptoms and may not require immediate provider notification. Choice C is incorrect because a morning fasting blood glucose of 185 mg/dL in a client with diabetes mellitus is elevated but not considered a critical finding that requires immediate reporting. Choice D is incorrect because pain 15 minutes after receiving an oral analgesic is a common occurrence and does not indicate an urgent need for provider notification.

Correct Answer: B

Rationale: The correct answer is B: 5-year-old with cerebral palsy. Children with cerebral palsy often face challenges in mobility, communication, and social interactions, which can contribute to the development of psychiatric problems. The physical limitations and the impact on daily activities can lead to feelings of frustration, isolation, and low self-esteem, increasing the risk of psychiatric issues. The other choices (A, C, D) do not inherently pose the same level of risk for developing psychiatric problems as cerebral palsy. Children with diabetes mellitus (A) can manage their condition with proper care, children with chronic renal disease (C) may face physical health challenges but not necessarily psychiatric problems, and a heart murmur (D) is a physical condition that typically does not directly affect mental health.

Correct Answer: C

Rationale: The most appropriate housing for Mr. Jones is group housing (Choice C) as it provides a supportive environment crucial for his recovery. Group housing offers peer support, structured routines, and access to counseling services, which can help him maintain sobriety and prevent relapse. Detoxification unit (Choice A) is not suitable as Mr. Jones has already been discharged from treatment. Nursing home (Choice B) is not appropriate as he does not require long-term care. Homeless shelter (Choice D) does not provide the necessary support for his complex needs. Group housing is the best option for Mr. Jones to ensure his continued recovery and well-being.

Correct Answer: A

Rationale: The correct answer is A: self-stigma. Self-stigma occurs when individuals internalize negative beliefs and attitudes about themselves due to their mental illness. In this scenario, the person feels shame for being sick, indicating self-stigma. Caregiver stigma (B) refers to stigma experienced by those caring for individuals with mental illness. Institutional stigma (C) pertains to stigma within organizations or systems. Public stigma (D) involves societal attitudes and discrimination towards individuals with mental illness. In this case, the individual's shame is self-directed, making self-stigma the most appropriate choice.