A nurse is performing an admission assessment on a client who has been diagnosed with schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

Answer is d. Maintain eye contact with the client and summarize the client’s feelings.

a. Identify other housing options and sources of transportation: While it is essential to address practical needs such as housing and transportation for clients who have experienced a crisis like a house fire, it is not the immediate priority when the client is in acute emotional distress. In this scenario, the client is expressing emotional distress and may not be ready to focus on practical solutions. Therefore, addressing the client's emotional needs should take precedence over addressing practical concerns.

b. Notify the facility chaplain to request scheduling an appointment: While spiritual support can be beneficial for individuals coping with trauma or loss, it should not be the immediate response when a client is in acute emotional distress. While the chaplain's support may be sought later as part of the client's holistic care, it should not precede addressing the client's immediate emotional needs.

c. Confirm that everything will be all right because belongings can be replaced: This option is incorrect because it offers false reassurance and dismisses the client's feelings about their loss. While it is true that belongings can be replaced, the emotional impact of losing possessions, especially in a traumatic event like a house fire, should not be trivialized. The client's feelings of distress and uncertainty are valid and should be acknowledged and addressed by the nurse.

d. Maintain eye contact with the client and summarize the client’s feelings: Correct. This action demonstrates therapeutic communication, which is crucial in providing an atmosphere of support and safety for the client. Maintaining eye contact shows empathy, support, and advocacy, indicating to the client that their feelings are being heard and validated. Summarizing the client's feelings allows the nurse to demonstrate active listening and understanding, fostering trust and rapport between the nurse and client. By prioritizing the client's emotional needs, the nurse can help the client begin to process their feelings and move towards coping and problem-solving.

In summary, the correct answer is d because maintaining eye contact with the client and summarizing their feelings demonstrates therapeutic communication, which is essential in providing support and validation for the client's emotional distress. This approach allows the nurse to establish rapport and trust with the client, facilitating further therapeutic interventions and support.

Choice A rationale:

Reality orientation is a technique commonly used in dementia care to help individuals be aware of time, place, and person. It is not directly related to the statement made by the client in the scenario about loving the daughter as much as the son based on academic performance.

Choice B rationale:

The correct choice. According to Eric Berne's theory of Transactional Analysis and Eric Erikson's psychosocial development stages, unconditional love is essential for fostering a positive sense of self-esteem. The statement made by the client to the daughter, linking love with better school performance, creates conditional love, implying that the daughter's worthiness of love is tied to her academic achievements. This can hinder the development of positive self-esteem.

Choice C rationale:

A sense of survival refers to basic human instincts related to self-preservation. It is not directly connected to the client's statement or the development of positive self-esteem in the context of parenting.

Choice D rationale:

A sense of responsibility involves understanding and fulfilling one's obligations. While it is important for parenting, the client's statement is more closely related to the concept of conditional love, which directly impacts self-esteem, as explained in choice B.