A 45-year-old client with a delusional disorder believes that their neighbor is spying on them through hidden cameras in their home. The client is anxious but willing to discuss their belief. What is the most appropriate nursing response to support reality testing?
"That’s impossible. Your neighbor wouldn’t do that."
"You should stop worrying about this; it’s not real."
"If you think there are cameras, we should find them together."
"I understand this is frightening for you. I haven’t seen any cameras, and the police haven’t found anything. Let’s talk about what might help you feel more secure."
The Correct Answer is D
Choice A reason: Directly rejecting the belief is non-therapeutic and may increase defensiveness, damaging trust.
Choice B reason: Telling the client to stop worrying invalidates their feelings and dismisses the emotional impact of the delusion.
Choice C reason: Participating in the delusion by “looking for cameras” reinforces the false belief, which is not supportive of reality testing.
Choice D reason: Acknowledging the client’s fear while gently presenting reality and shifting toward problem-solving helps maintain trust and supports reality testing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:Placing a client in a seclusion room is not appropriate unless they pose an immediate safety risk to themselves or others. Seclusion can increase agitation in a manic client and is not a standard room assignment for managing mania.
Choice B reason:A private room close to the nursing station allows for close monitoring of the client’s behavior, which is critical during the manic phase due to impulsivity and high energy. This setup ensures safety while providing a controlled environment without unnecessary isolation.
Choice C reason:A private room in a quiet location may reduce stimulation, which is beneficial, but it may limit the ability to closely monitor the client. Proximity to the nursing station is preferred to ensure rapid intervention if needed.
Choice D reason:A semi-private room with a roommate who has a similar diagnosis could lead to overstimulation or conflict, as two manic clients may exacerbate each other’s symptoms. A private room is more appropriate for managing mania.
Correct Answer is A
Explanation
Choice A reason:The total daily dose of quetiapine is 800 mg, divided into two doses, meaning each dose is 400 mg (800 mg ÷ 2). With 200 mg tablets, each dose requires 400 mg ÷ 200 mg = 2 tablets. This is the correct calculation for the number of tablets per dose.
Choice B reason:Four tablets per dose would result in 800 mg per dose (4 × 200 mg), totaling 1600 mg daily, which doubles the prescribed daily dose of 800 mg. This is incorrect and could lead to an overdose.
Choice C reason:Five tablets per dose would result in 1000 mg per dose (5 × 200 mg), totaling 2000 mg daily, far exceeding the prescribed 800 mg daily dose. This is incorrect and unsafe.
Choice D reason:Three tablets per dose would result in 600 mg per dose (3 × 200 mg), totaling 1200 mg daily, which exceeds the prescribed 800 mg daily dose. This is incorrect and not aligned with the prescription.
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