A nurse is caring for a client with paranoid personality disorder who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?

Disclose some personal information to the client to demonstrate approachability.

Approach the client frequently throughout the day for brief interactions.

Adopt a neutral attitude when providing care.

Wait for the client to initiate interaction.

Answer and Explanation

The Correct Answer is C

C. A neutral attitude communicates respect, professionalism, and non-threatening intentions. It helps to minimize the client's feelings of being scrutinized or manipulated and creates a safe environment for the client to engage in therapeutic interactions.

A. Disclosing personal information may further exacerbate the client's mistrust and suspicion, as they may interpret it as confirmation of their paranoid beliefs or as an attempt to manipulate them.

B. Approaching the client frequently throughout the day may be overwhelming and increase the client's suspicion. Clients with paranoid personality disorder often feel threatened by perceived intrusions into their personal space or privacy.

D. While it's essential to respect the client's autonomy and boundaries, waiting for the client to initiate interaction may prolong the establishment of a therapeutic relationship, especially with a client who is suspicious and mistrustful.

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Correct Answer is D

Explanation

D. By offering assistance with getting ready and framing participation in activities as a manageable task, the nurse can help the client overcome feelings of inertia and initiate engagement. It acknowledges the client's current difficulties while providing gentle encouragement to participate in the unit's programs.

A. This response may come across as dismissive of the client's feelings and struggles. It may also increase feelings of guilt or inadequacy in the client, potentially worsening their depressive symptoms.

B. It offers support without pressure and allows the client to take the initiative when they feel comfortable to engage in activities. However, it may not provide enough encouragement or assistance for the client to overcome their depressive symptoms and initiate activity.

C. Encouraging prolonged withdrawal from activities without offering support or motivation to engage may contribute to further isolation and exacerbate depressive symptoms.

A. Check the client's belongings for additional drugs. B. Pad the side rails of the bed because seizures are likely. C. Prepare a dose of ipecac, an emetic. D. Monitor respiratory function.

Correct Answer is D

Explanation

D. Barbiturates can cause respiratory depression, hypoventilation, and potentially respiratory arrest, which can lead to hypoxia and cardiac arrest if not promptly recognized and managed.

A. While it's important to assess for any additional drugs or substances that the client may have ingested, this action is not the priority when managing a client with a barbiturate overdose.

B. Seizures can occur as a result of barbiturate overdose, but respiratory depression is the more immediate and life-threatening concern.

C. Ipecac is no longer recommended for the induction of vomiting in cases of drug overdose due to the risk of complications such as aspiration pneumonia and delayed treatment.

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A nurse is caring for a client with paranoid personality disorder who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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