Isadora is a middle-aged woman living in a group home after being discharged from a psychiatric institution nearly 20 year ago. Isadora keeps to herself, stays in her room most of the day, and only ventures out for meals. Cassandra, the house manager, encourages Isadora to:

Correct Answer: B

Rationale: The correct answer is B: Join a day program clubhouse. This option is the most appropriate as it offers Isadora socialization, structured activities, and support, which can help her overcome isolation and improve her mental well-being. Looking for a job (A) may be too overwhelming for Isadora at this point. Assisting in the kitchen (C) may not address her socialization needs. Taking on a roommate (D) could potentially increase Isadora's stress levels instead of addressing her social isolation.

Correct Answer: B

Rationale: The correct answer is B: Milieu. In behavioral care, the milieu refers to the therapeutic environment or setting where the treatment takes place. It includes factors such as the physical environment, staffing, structure, and culture of the treatment setting. Understanding the milieu is crucial for providing effective care and promoting positive outcomes for patients. Signs and symptoms (choice A) are not service variables but indicators of a patient's condition. Risk (choice C) is related to assessing potential harm or danger to the patient and is not a service variable. Social support (choice D) is important for patient recovery but is not a service variable directly associated with determining settings along the continuum of behavioral care.

Correct Answer: B

Rationale: The goal for the orientation phase is to establish trust. This is crucial for building a strong nurse-client relationship. Trust forms the foundation for effective communication and collaboration. By establishing trust, the nurse can create a safe and supportive environment for the client to open up and engage in the therapeutic process. Exploring self-perceptions (choice A) is typically done in the working phase, not the orientation phase. Promoting change (choice C) and evaluating goal attainment (choice D) are also more relevant to the later phases of the relationship when interventions and outcomes are being assessed. Therefore, the correct answer is B as it aligns with the primary focus of the orientation phase.

Correct Answer: C

Rationale: Rationale: C is correct because the patient is exhibiting symptoms of tardive dyskinesia, a side effect of long-term antipsychotic use. It is crucial for the nurse to document these symptoms accurately to inform the healthcare team. A: Asking about side effects is important but doesn't address the specific symptoms observed. B: Contacting the physician for a different medication order may be necessary, but documenting the symptoms first is crucial. D: Tapering off the medication should only be done under medical supervision and after proper assessment, not based solely on observed symptoms.

Correct Answer: D

Rationale: The correct answer is D because when a client makes a written application to be admitted to a psychiatric facility, they typically retain the right to make decisions about their discharge unless they are determined to be a danger to themselves or others. This is in line with the principle of autonomy and informed consent in healthcare. Choices A is incorrect because civil rights are not necessarily all revoked upon admission. Choice B is incorrect as clients usually have the right to participate in discharge decisions. Choice C is incorrect as not all clients admitted to a psychiatric facility are necessarily deemed a danger to self or others.