A nurse is caring for a client who has schizophrenia. The client states, "They lie about me all the time and are trying to poison my food." Which of the following responses should the nurse make?

"You seem to be having some very frightening thoughts."

"Why do you think you are being lied about and poisoned?"

"You are mistaken. Nobody is lying about you or trying to poison you."

"Who is lying about you and trying to poison you?"

Answer and Explanation

The Correct Answer is A

Choice A reason: This response acknowledges the client's feelings without agreeing with the delusion or challenging their reality, which can help in building trust and rapport.

Choice B reason: Asking "Why do you think you are being lied about and poisoned?" could potentially reinforce the delusion and lead the client to further justify their beliefs.

Choice C reason: Directly telling the client they are mistaken can be confrontational and may damage the therapeutic relationship.

Choice D reason: Asking "Who is lying about you and trying to poison you?" can validate the delusion and is not a therapeutic response.

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Correct Answer is B

Explanation

Choice A reason: While relaxation techniques are beneficial, providing structure is often the first step in helping clients with OCD manage their symptoms, as it can reduce anxiety and prevent time for obsessions and compulsions to occur.

Choice B reason: A structured schedule can help the client focus on tasks and activities, reducing the time available for obsessive thoughts and compulsive behaviors.

Choice C reason: Identifying expectations is important, but it should come after establishing a structured routine that can support the client's participation in care.

Choice D reason: Discussing alternative coping strategies is a part of treatment, but initially providing a structured schedule can offer immediate relief and a sense of control for the client.

A. Fear of heights B. Fear of blood C. Fear of shopping in a large mall D. Fear of speaking

Correct Answer is C

Explanation

Choice A reason: Fear of heights is known as acrophobia, not agoraphobia.

Choice B reason: Fear of blood is known as hemophobia, not agoraphobia.

Choice C reason: Agoraphobia is the fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong, such as shopping in a large mall.

Choice D reason: Fear of speaking is known as glossophobia, not agoraphobia.

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A nurse is caring for a client who has schizophrenia. The client states, "They lie about me all the time and are trying to poison my food." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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