The nurse observes a confused patient pacing back and forth in the dining room. The patient yells, "The doctor is going to make us all drink poison!" The most appropriate intervention at this time would be to:
a. ask the patient why he would say something like that.
b. change the subject to disrupt the patient's thought process.
c. tell the patient that he should probably think of something else.
d. quietly ask the patient to explain the statement.
ANS: D
Seeking clarification encourages the patient to expand on a topic that may be confusing or that seems contradictory. Asking "why" questions implies criticism, may make the patient defensive, tends to limit conversation, requires justification of actions, and focuses on a problem rather than a possible solution. Changing the subject avoids exploration of the topic raised by the patient, and demonstrates the nurse's discomfort with the topic introduced by the patient. Giving advice implies a lack of confidence in the patient to make a healthy decision
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