A patient with schizophrenia tells the nurse, "I eat skiller. Tend to end. Easter. It blows away. Get it?" Select the nurse's best response
a. "Nothing you are saying is clear."
b. "Your thoughts are very disconnected."
c. "Try to organize your thoughts, and then tell me again."
d. "I am having difficulty understanding what you are saying."
ANS: D
When a patient's speech is loosely associated, confused, and disorganized, pretending to understand is useless. The nurse should tell the patient that he or she is having difficulty understanding what the patient is saying. If a theme is discernible, ask the patient to talk about the theme. The incorrect options tend to place blame for the poor communication with the patient. The correct response places the difficulty with the nurse rather than being accusatory.
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