A client is having trouble remembering to take his antipsychotic medication, risperidone 3 mg PO, BID. The treatment team at the clinic he attends is considering starting him on risperidone 10 mg IM every 2 weeks. The rationale for this is:

The correct answer is d.

Choice A Reason:

The statement “Bureaucratic” is incorrect. Bureaucratic leadership is characterized by strict adherence to rules and procedures, with decisions made based on established policies. While this style ensures consistency and compliance, it does not typically involve the direct and decisive intervention seen in the scenario described. Bureaucratic leaders focus more on following protocols rather than making quick, authoritative decisions.

Choice B Reason:

The statement “Laissez-Faire” is incorrect. Laissez-Faire leadership is a hands-off approach where leaders provide minimal direction and allow team members to make their own decisions. This style is the opposite of what is demonstrated in the scenario, where the nurse takes immediate control of the situation. Laissez-Faire leaders typically avoid intervening directly and prefer to let issues resolve themselves.

Choice C Reason:

The statement “Democratic” is incorrect. Democratic leadership involves participative decision-making, where leaders seek input and feedback from team members before making decisions. In the scenario, the nurse does not seek input from the group but instead makes a unilateral decision to handle the matter and move on. This approach is not characteristic of democratic leadership, which values collaboration and consensus.

Choice D Reason:

The statement “Autocratic” is correct. Autocratic leadership is characterized by individual control over decisions, with little input from group members. The nurse’s behavior in the scenario—taking charge of the situation and making a quick decision without consulting the group—is indicative of an autocratic leadership style. Autocratic leaders are decisive and often make decisions independently, focusing on efficiency and control.

Choice A Reason:

Ask open-ended questions.

While asking open-ended questions can be useful in many therapeutic settings, it may not be the best approach when dealing with delusional clients. Open-ended questions can sometimes lead to more elaborate delusional thinking and may not help in grounding the client in reality. Instead, focusing on the present moment and concrete reality can be more effective in managing delusions.

Choice B Reason:

Focus on what is happening in the here and now.

This is the correct response. Focusing on the present moment helps to ground the client in reality and can reduce the intensity of delusional thoughts. By directing the client’s attention to their immediate environment and current activities, the nurse can help the client stay connected to reality and reduce the impact of their delusions.

Choice C Reason:

Assume knowledge of what is meant when the client talks about “they.”

Assuming knowledge of what the client means when they refer to “they” can reinforce delusional thinking. It is important for the nurse to clarify and understand the client’s perspective without validating the delusion. This approach helps maintain a therapeutic relationship while not reinforcing false beliefs.

Choice D Reason:

Limit contact to one or two short interactions daily.

Limiting contact to one or two short interactions daily is not an effective strategy for managing delusions. Clients with delusions often need consistent and supportive interactions to help them stay grounded in reality. Frequent, brief interactions can provide the necessary support and reassurance without overwhelming the client.