A nurse is beginning a therapeutic relationship with a client who has paranoid personality disorder.
Which of the following strategies should the nurse plan to use?.

Demonstrate a neutral demeanor.

Be vague when answering the client's questions about instructions.

Ask the client why he is suspicious of others.

Use an overly friendly approach.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Demonstrating a neutral demeanor helps build trust with a client who has paranoid personality disorder. It’s important to avoid showing too much emotion, which could be misinterpreted by the client.

Choice B rationale:

Being vague when answering the client’s questions about instructions could increase the client’s paranoia. Clear and direct communication is essential.

Choice C rationale:

Asking the client why he is suspicious of others could lead to defensive behavior. It’s better to focus on building trust and understanding.

Choice D rationale:

Using an overly friendly approach could be perceived as insincere or manipulative by a client with paranoid personality disorder. A neutral demeanor is more effective.

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Correct Answer is B

Explanation

Choice A rationale:

A consistent state of depression is not indicative of delirium, but rather a mood disorder.

Choice B rationale:

Fluctuating levels of orientation are a hallmark sign of delirium and should be reported to the provider.

Choice C rationale:

Obsessive behaviors are not typically associated with delirium, but may be indicative of an anxiety disorder.

Choice D rationale:

Gradual memory loss is more indicative of dementia, not delirium, which is typically a sudden onset.

A. Encouraging the client to attend a daily exercise program on the unit. B. Maintaining the client's confidentiality about a substance use disorder. C. Reinforcing information on the potential adverse effects of a medication with the client. D. Respecting the client's right to refuse to attend a group therapy session.

Correct Answer is C

Explanation

Choice A rationale:

Encouraging the client to attend a daily exercise program on the unit is beneficial for the client’s health, but it does not demonstrate the ethical principle of veracity, which involves truthfulness and honesty.

Choice B rationale:

Maintaining the client’s confidentiality about a substance use disorder is an important aspect of nursing care, but it demonstrates the ethical principle of confidentiality, not veracity.

Choice C rationale:

Reinforcing information on the potential adverse effects of a medication with the client is an example of veracity. The nurse is being truthful and transparent about the potential risks associated with the medication.

Choice D rationale:

Respecting the client’s right to refuse to attend a group therapy session demonstrates the ethical principle of autonomy, not veracity.

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A nurse is beginning a therapeutic relationship with a client who has paranoid personality disorder.
Which of the following strategies should the nurse plan to use?.