A patient with paranoid schizophrenia tells the nurse, "The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say." Which response by the nurse would be most therapeutic?
a. "Let's talk about something other than the CIA."
b. "It sounds like you're concerned about your privacy."
c. "The CIA is prohibited from operating in health care facilities."
d. "You have lost touch with reality, which is a symptom of your illness."
ANS: B
It is important not to challenge the patient's beliefs, even if they are unrealistic. Challenging undermines the patient's trust in the nurse. The nurse should try to understand the underlying feelings or thoughts the patient's message conveys. The correct response uses the therapeutic technique of reflection. The other comments are nontherapeutic. Asking to talk about something other than the concern at hand is changing the subject. Saying that the CIA is prohibited from operating in health care facilities gives false reassurance. Stating that the patient has lost touch with reality is truthful but uncompassionate.
You might also like to view...
The nurse educator is differentiating primary immunodeficiency diseases from secondary immunodeficiencies. What is the defining characteristic of primary immunodeficiency diseases?
A) They require IVIG as treatment. B) They are the result of intrauterine infection. C) They have a genetic origin. D) They are communicable.
Which of the following people would be the best candidate for use of an intrauterine device (IUD)?
a. A woman in a mutually monogamous, stable relationship b. A single woman who is actively dating c. A woman who cannot afford oral contraceptives d. A woman with a prior history of pelvic inflammatory disease
There are two types of risk factors associated with COPD. What is a host factor?
A) Smoking B) Genetic tendency C) Indoor toxins D) Impaired breathing mechanism
The nurse is conducting a medication history with a patient who asks, "What happens to all of these medications that I take?" The nurse should instruct on the location where most drugs are metabolized, which would be the:
a. kidneys c. skin b. adrenal glands d. liver