A nurse is beginning a therapeutic relationship with a client who has paranoid personality disorder.
Which of the following strategies should the nurse plan to use?.

Demonstrate a neutral demeanor.

Be vague when answering the client's questions about instructions.

Ask the client why he is suspicious of others.

Use an overly friendly approach.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Demonstrating a neutral demeanor helps build trust with a client who has paranoid personality disorder. It’s important to avoid showing too much emotion, which could be misinterpreted by the client.

Choice B rationale:

Being vague when answering the client’s questions about instructions could increase the client’s paranoia. Clear and direct communication is essential.

Choice C rationale:

Asking the client why he is suspicious of others could lead to defensive behavior. It’s better to focus on building trust and understanding.

Choice D rationale:

Using an overly friendly approach could be perceived as insincere or manipulative by a client with paranoid personality disorder. A neutral demeanor is more effective.

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Correct Answer is B

Explanation

Choice A rationale:

This statement indicates a delusion, not a command hallucination. Delusions are fixed false beliefs that are not based in reality.

Choice B rationale:

This statement indicates a command hallucination. Command hallucinations involve hearing voices that direct the person to take action.

Choice C rationale:

This statement indicates paranoia, not a command hallucination. Paranoia involves intense anxious or fearful feelings and thoughts often related to persecution or threat.

Choice D rationale:

This statement indicates a visual hallucination, not a command hallucination. Visual hallucinations involve seeing things that aren’t there.

A. A client who has bipolar disorder and is continuously pacing at the end of the hall. B. A client who is standing in her room, yelling obscenities and throwing her clothes. C. A client in the dayroom who is screaming at other clients about what is on the television. D. A client who is repeatedly approaching the nurses' station to request medication for his anxiety.

Correct Answer is B

Explanation

Choice A rationale:

While pacing can indicate anxiety, this client is not currently a threat to themselves or others.

Choice B rationale:

This client is exhibiting aggressive behavior and could potentially harm themselves or damage property.

Choice C rationale:

Although this client’s behavior is disruptive, it is not immediately dangerous.

Choice D rationale:

This client’s repeated requests indicate anxiety, but they are not in immediate danger.

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A nurse is beginning a therapeutic relationship with a client who has paranoid personality disorder.
Which of the following strategies should the nurse plan to use?.