One evening, a client with schizophrenia leaves his room and begins marching in the hall. When approached by the nurse, the client says, "God says I'm supposed to guard the area." Which of the following responses would be best?
A) "I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice."
B) "The voices are part of your illness and they will leave in time."
C) "This guarding responsibility can make you tired. You rest for now, and I'll guard a while."
D) "You are just imagining these things. Do not pay any attention to the voices."
A
Feedback: Answer A validates that the client's experience is real to him, yet represents reality. Answer B is not appropriate to the client's statement. Answer C feeds into the client's statement. Answer D does not deal with the patient in a serious manner.
You might also like to view...
Outline the sequence of the process that stimulates the increase in the production of red blood cells. (Separate letters by a comma and space as follows: A, B, C, D)
a. Kidneys release erythropoietic factor b. Increase in red blood cell production c. Enzyme stimulates red bone marrow d. Oxygen delivery increased to the tissues e. Oxygen delivery decreased to the tissues f, Decrease in red blood cell production
A 32-year-old paraplegic has been admitted to the hospital for antibiotic therapy to treat pneumonia. He lives independently and has developed strong upper-body strength to maximize his independence
Which transfer device should be used when transferring him from the bed to his wheelchair? 1) Mechanical lift 2) Transfer belt 3) Draw sheet 4) Transfer board
A patient is taking warfarin (Coumadin) daily to prevent blood clots from forming in deep veins. Which statement made by the patient indicates that more teaching is needed about this therapy?
a. "I have been eating more salads and other green, leafy vegetables to prevent con-stipation." b. "I have been using acetaminophen (Tylenol) instead of aspirin for pain." c. "Instead of a safety razor, I have been using an electric shaver." d. "On hot days, I make sure to drink at least two quarts of water."
Care of the spirit, as well as promoting health of the body, is done very effectively by which professional nursing specialty?
A. Church-based nurses B. Community/public health nurses C. Parish nurses D. Public health nurses