A client with paranoid delusions refuses a chest x-ray citing fears. What nursing response is appropriate?

A client with paranoid delusions refuses a chest x-ray citing fears. What nursing response is appropriate?

• A. Do you think people want to kill you?
• B. You don't have to worry about that.
• C. I don’t want to hear about concerns regarding the technicians.
• D. Where did you get the idea someone is trying to kill you?

Answer: (A)

The nursing response that involves asking the client if they think people want to kill them is effective as it acknowledges the client’s feelings and delusions while encouraging them to express their thoughts and concerns further. This approach can help build rapport and trust, which are essential when dealing with clients experiencing paranoia. By asking the client to elaborate on their beliefs, the nurse demonstrates an understanding of the client’s experience and provides an opportunity for the client to discuss their fears in a safe environment. This strategy not only validates the client's feelings but also opens the door for therapeutic dialogue that can facilitate further assessment and potentially guide interventions to address the client's delusions and anxieties in a supportive manner. Other responses may not effectively address the client’s feelings. Dismissing the situation or redirecting the focus away from the client’s expressed fears might create a sense of invalidation, leading to increased suspicion or resistance from the client. Therefore, engaging the client in conversation about their specific fears can aid in their overall care and therapeutic relationship.

The nursing response that involves asking the client if they think people want to kill them is effective as it acknowledges the client’s feelings and delusions while encouraging them to express their thoughts and concerns further. This approach can help build rapport and trust, which are essential when dealing with clients experiencing paranoia.

By asking the client to elaborate on their beliefs, the nurse demonstrates an understanding of the client’s experience and provides an opportunity for the client to discuss their fears in a safe environment. This strategy not only validates the client's feelings but also opens the door for therapeutic dialogue that can facilitate further assessment and potentially guide interventions to address the client's delusions and anxieties in a supportive manner.

Other responses may not effectively address the client’s feelings. Dismissing the situation or redirecting the focus away from the client’s expressed fears might create a sense of invalidation, leading to increased suspicion or resistance from the client. Therefore, engaging the client in conversation about their specific fears can aid in their overall care and therapeutic relationship.