A client with schizophrenia approaches the nurse with a look of distress and anguish on his face. He says, “Can’t you hear him? It’s the devil. He’s telling me I’m going to hell.” Which is the most appropriate response by the nurse?

Choice A Reason: Teach the client to avoid “I” statements related to the expression of feelings

Teaching a client to avoid “I” statements is not a recommended intervention. In fact, “I” statements are often encouraged in therapeutic settings because they help individuals express their feelings without blaming others. For example, saying “I feel angry when…” helps to communicate emotions constructively and can be a part of anger management strategies.

Choice B Reason: Tell the client to stop using a loud angry voice

While it might seem logical to ask a client to stop using a loud, angry voice, this approach can be counterproductive. It may escalate the situation by making the client feel unheard or invalidated. Instead, it is more effective to acknowledge the client’s feelings and then guide them towards expressing their anger in a more appropriate manner.

Choice C Reason: Use therapeutic touch to convey empathy

Therapeutic touch involves using physical touch to convey empathy and support. However, its effectiveness can vary depending on the client’s comfort with touch and cultural background. Some clients may find touch comforting, while others may find it intrusive or uncomfortable. Therefore, it is important to assess the client’s preferences and obtain consent before using therapeutic touch.

Choice D Reason: Clearly explain the consequences of the behavior

This is the correct answer. Clearly explaining the consequences of inappropriate behavior helps set boundaries and provides the client with an understanding of the impact of their actions. It is a crucial part of behavior management and helps the client learn appropriate ways to express their emotions. This approach is aligned with cognitive-behavioral strategies that focus on understanding the relationship between thoughts, feelings, and behaviors.

Choice A Reason:

Aggressive and angry.

Aggressive and angry behavior is not indicative of apathy. Apathy is characterized by a lack of interest, enthusiasm, or concern. Aggression and anger are more likely to be associated with other symptoms of schizophrenia, such as paranoia or frustration, rather than apathy.

Choice B Reason:

Concerned over recent events.

Being concerned over recent events shows an active engagement with one’s environment and emotions. This is the opposite of apathy, which involves a lack of interest or concern. Therefore, this behavior does not align with the definition of apathy.

Choice C Reason:

Indifferent to their surroundings.

This is the correct response. Indifference to one’s surroundings is a clear sign of apathy. In schizophrenia, apathy is a common negative symptom and involves a diminished ability to initiate and sustain activities, including social interactions. This lack of interest or motivation is a key feature of apathy.

Choice D Reason:

Supportive in group.

Being supportive in a group setting indicates active participation and concern for others, which is not consistent with apathy. Apathy would manifest as a lack of engagement or interest in group activities and interactions.