A nurse is participating in a hospital committee to discuss the rationing of care and resources during a pandemic.
Which of the following behaviors should the nurse identify as important in providing ethical and empathetic nursing care?

Choice A rationale
The statement that the milieu consists of the physical and psychosocial environmental factors indicates an understanding of therapeutic milieu. The therapeutic milieu refers to the structured and safe environment that is created in a mental health setting to promote therapeutic interaction and healing.
Choice B rationale
The positioning of chairs around the perimeter of the day room does not necessarily indicate an understanding of therapeutic milieu. While the physical arrangement of the environment can contribute to the therapeutic milieu, it is not the defining aspect.
Choice C rationale
The statement that therapeutic milieu requires unstructured programming, allowing clients to focus on their interests, does not accurately reflect the concept of therapeutic milieu. While client interests are important, therapeutic milieu often involves structured activities designed to promote therapeutic interaction and healing.
Choice D rationale
The statement that clients can keep any personal items in their rooms does not necessarily indicate an understanding of therapeutic milieu. While personal items can contribute to a sense of comfort and safety, therapeutic milieu involves more than just the physical environment.

Choice A rationale
The adolescent’s experimentation with drugs could be a coping mechanism to deal with the trauma of the sexual assault and the subsequent posttraumatic stress disorder (PTSD).
Substance use, including drug use, is often a maladaptive coping strategy used by individuals

who have experienced trauma to numb their feelings, escape from their reality, or attempt to regain control. This must indeed be a difficult time for both the adolescent and the parent.
Choice B rationale
While experimentation is a part of normal adolescent behavior, it is not normal or healthy for an adolescent to use drugs, especially in response to a traumatic event such as a sexual assault. Drug use can lead to addiction, health problems, and further psychological distress. Therefore, it is something to be concerned about and addressed appropriately.
Choice C rationale
While it is important to understand and address the parent’s concerns, the focus should be on the adolescent’s needs. The adolescent is dealing with the aftermath of a sexual assault and a diagnosis of PTSD, and is using drugs. These are serious issues that need to be addressed with professional help. The question of which behavior to address first should be determined based on the adolescent’s immediate safety and well-being.
Choice D rationale
It is not helpful to label the adolescent’s behavior as misbehavior or to compare them to their siblings. Each child is unique and may react differently to stress and trauma. Instead of focusing on rules and comparisons, it would be more beneficial to provide support, understanding, and appropriate professional help.