The client received aripiprazole (Abilify) on admission to the inpatient unit with a diagnosis of schizophrenia, paranoid type. Which of the following would the nurse note as a sign that the aripiprazole is becoming effective?
1. The client paces in the hall and engages in solitary activities most of the day.
2. The client sleeps for shorter periods of time during the day.
3. The client establishes eye contact and remains in conversation with the nurse for longer periods.
4. The client eats only the food that is in its original container such as individual packages of crackers.
3
Rationale: Because suspiciousness is a central feature of paranoid delusions, efficacy is shown by the client demonstrating behaviors that suggest increasing trust in the nurse. Sleeping less during the day is not a sign that aripiprazole is alleviating psychotic symptoms. Engaging in solitary activities and eating prepackaged food are signs of paranoia.
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