A nurse is contributing to the plan of care for a client who has paranoid schizophrenia. Which of the following interventions should the nurse recommend to be included in the plan of care?

Assume an upbeat friendly attitude when talking with client.

Allow patient to uncover/unwrap items on the food tray.

Use touch to calm the client during periods of anxiety.

Rotate the client’s staff assignments daily.

Answer and Explanation

The Correct Answer is B

Choice A reason: An overly friendly attitude may increase suspicion in a client with paranoia. A calm, neutral approach is more therapeutic.

Choice B reason: Allowing the client to unwrap food items helps reduce paranoia about tampering or poisoning. This intervention promotes trust and reduces anxiety.

Choice C reason: Using touch can be misinterpreted and increase paranoia or agitation. Physical contact should be avoided unless necessary for safety.

Choice D reason: Rotating staff frequently can increase mistrust. Consistency in caregivers helps build rapport and reduce paranoia.

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Correct Answer is C

Explanation

Choice A reason: Allowing free interaction worsens disruption and does not protect other clients’ rights to a therapeutic environment.

Choice B reason: Threatening restraints is inappropriate and escalates agitation. Restraints are only used as a last resort for safety, not for excessive talking.

Choice C reason: Escorting the client to her room removes her from the disruptive environment and provides a calmer space. This is the most appropriate intervention to manage manic behavior.

Choice D reason: Practicing social interaction is useful in stable phases, but during acute mania the client cannot control excessive talking. This is not appropriate at this time.

A. Follow the agency's guidelines for reporting suspected abuse. B. Check the bruises at the next visit to the client's home. C. Arrange referral for family therapy to deal with home stressors. D. Institute more frequent visits to the client’s home.

Correct Answer is A

Explanation

Choice A reason: Suspected abuse must be reported immediately according to mandated reporting laws and agency guidelines. This ensures the client’s safety and initiates protective interventions.

Choice B reason: Waiting until the next visit delays action and places the client at continued risk.

Choice C reason: Family therapy may be helpful but is not appropriate until abuse is addressed and safety ensured.

Choice D reason: Increasing visits does not resolve the immediate risk of abuse. Reporting is the priority.

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A nurse is contributing to the plan of care for a client who has paranoid schizophrenia. Which of the following interventions should the nurse recommend to be included in the plan of care?

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