A patient with a mental illness says, "I have to go to the bank. The voices are telling me to go there." Which response by the nurse is best?
a. "Do you need money?"
b. "I will call you a cab later. Right now, it is time for therapy."
c. "Why do you think the voices are telling you to go to the bank?"
d. "I want to help you focus away from the voices. I am real, they are not."
ANS: D
The nurse needs to validate the patient's concern without exploring and focusing on the delusion. The patient needs to know what is real and what is not. B. Calling a cab and focusing on therapy does not validate the patient's concern. C. Asking the patient about the voices encourages the patient to focus on the delusion. D. Asking about money might be appropriate for an older person with dementia, but a patient with schizophrenia needs to be brought back to reality.
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