A client with residual schizophrenia, aged 60 years, spent 5 years in a state hospital before being

Question

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 institutionalization.
b. cognitive deterioration from schizophrenia.
c. brain damage from recreational drug use.
d. neuroleptic drug side effects.

Answer 1

A
Institutionalization 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, institutionalization 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.