The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?

Explain that these beliefs are related to her illness.

Explain that distrust is related to feeling anxious.

Initiate short, frequent contacts with the client.

Offer to keep the belongings at the nurse's desk.

Answer and Explanation

The Correct Answer is C

(A) Explain that these beliefs are related to her illness: While it is important to educate the client about their illness, directly challenging their delusions may increase distrust and anxiety. This approach might make the client feel misunderstood and less likely to trust the nurse.

(B) Explain that distrust is related to feeling anxious: This explanation might not be well-received by the client and could be perceived as dismissive of their concerns. It may not effectively address the client’s immediate need for trust and reassurance.

(C) Initiate short, frequent contacts with the client: This approach helps build trust through consistent and reliable interactions. It allows the nurse to establish a rapport without overwhelming the client, thereby promoting a sense of safety and trust. Regular, brief interactions can help the client feel more comfortable and secure.

(D) Offer to keep the belongings at the nurse’s desk: This action might be perceived as an attempt to take control of the client’s belongings, which could reinforce their delusions and decrease trust. It is important to respect the client’s need to keep their belongings close to them.

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Correct Answer is A

Explanation

A) Staying quietly with the client is the best approach in this situation. By remaining present and calm, the nurse can provide a sense of safety and support. This non-confrontational presence may help the client feel more secure and reduce her agitation over time.

B) Telling the client that she is out of control may escalate her frustration and feelings of being judged. This could worsen the situation rather than help it, as it does not offer any constructive feedback or support.

C) Ignoring the client's acting out behavior is not appropriate. Acknowledging her feelings and providing support is essential, even if her behavior is challenging. Ignoring her could lead to further escalation and feelings of isolation.

D) Distracting her by offering finger foods could be an effective strategy if the client is calm enough to engage in that activity. However, if she is currently shouting and screaming, she may not be receptive to distraction techniques. Addressing her emotional state first is more critical.

A. Explains answers to open-ended questions. B. Reports enjoyment from assigned activities. C. Shares a personal story with peers. D. Performs activities of daily living.

Correct Answer is D

Explanation

(A) Explains answers to open-ended questions:While explaining answers to open-ended questions indicates cognitive engagement, it does not directly address avolition, which is characterized by a lack of motivation to perform purposeful activities.

(B) Reports enjoyment from assigned activities:Reporting enjoyment from activities is a positive sign, but it does not necessarily indicate an improvement in the motivation to initiate and complete tasks independently.

(C) Shares a personal story with peers:Sharing personal stories can demonstrate social engagement, but it does not directly reflect an improvement in avolition, which involves the motivation to perform daily tasks.

(D) Performs activities of daily living:Performing activities of daily living (ADLs) demonstrates an improvement in avolition, as it shows the client is motivated to take care of themselves and engage in necessary daily tasks. This behavior directly aligns with the goal of improving avolition.

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The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?

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