Question

the nurse is planning discharge for a male client with schizophrenia. the client insists that he is returning to his apartment, although the healthcare provider informed him that he will be moving to a boarding home. which is the most important nursing problem for discharge planning?

ineffective denial related to situational anxiety.
ineffective coping related to inadequate support.
social isolation related to difficult interactions.
self-care deficit related to cognitive impairment.

Explanation:

Analyze client behavior and statements

The client is insisting on returning to his apartment despite being explicitly informed by the healthcare provider that he is moving to a boarding home. This refusal to acknowledge or accept the reality of the discharge plan represents a defense mechanism to minimize anxiety.

Identify the primary nursing diagnosis

The client's refusal to face the reality of his living situation constitutes denial. Because this denial interferes with safe and effective discharge planning, it is classified as ineffective denial.

Evaluate the options

• "Ineffective denial related to situational anxiety" directly addresses the client's refusal to acknowledge the reality of his discharge destination.
• "Ineffective coping", "Social isolation", and "Self-care deficit" do not directly address the immediate conflict between the client's belief and the actual discharge plan.

Answer:

• Ineffective denial related to situational anxiety. (Correct answer)
• Ineffective coping related to inadequate support.
• Social isolation related to difficult interactions.
• Self-care deficit related to cognitive impairment.