Psychotic Disorders no. 4072

Psychotic Disorders no. 4072

QUESTION: A client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. He's shouting that the government of France is trying to assassinate him. Which response is most appropriate?

✘O a.) "I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you."
✓O b.) "I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this."
✘O c.) "You're wrong. Nobody is trying to kill you."
✘O d.) "A foreign government is trying to kill you? Please tell me more about it."

RATIONALE

RATIONALE: Responses should focus on reality while acknowledging the client's feelings. Arguing with the client or denying his belief isn't therapeutic. Arguing can also inhibit development of a trusting relationship. Continuing to talk about delusions may aggravate the psychosis. Asking the client if a foreign government is trying to kill him may increase his anxiety level and can reinforce his delusions.
NURSING PROCESS STEP: Implementation
CLIENT NEEDS CATEGORY: Psychosocial integrity
CLIENT NEEDS SUBCATEGORY: None
COGNITIVE LEVEL: Analysis