Which nursing problem should be included on the treatment plan?

• A. Impaired adjustment.
• B. Social isolation.
• C. Anxiety.
• D. Confusion.

Answer: (B)

In schizophrenia, addressing social functioning is essential because withdrawal from others and limited social contact are common and have a direct impact on recovery. Social isolation is a clear, observable nursing problem that guides concrete interventions. By prioritizing this issue on the treatment plan, you can target ways to reengage the client, reduce withdrawal, and improve participation in daily activities and therapy.

Think about why this matters: negative symptoms like avolition and diminished affect often lead to withdrawing from social interactions. This isolation can worsen prognosis if not addressed, so the plan should include strategies to promote meaningful social contact and skills. Interventions might involve inviting the client to join structured group activities, providing facilitated social skills practice, establishing a predictable routine that includes social time, and offering a supportive environment that reduces fear of judgment and stigma.

While anxiety and confusion can occur, they are not as specific or directly actionable within a schizophrenia-focused treatment plan. Anxiety is a common but nonspecific symptom, and confusion is not typical of stable schizophrenia without another explanation such as delirium or severe cognitive impairment. Impaired adjustment is relevant in some contexts but is less precise for guiding targeted social-reintegration efforts compared with social isolation, which directly informs interventions aimed at increasing social interaction and engagement.