Schizophrenia Q 16
A client with paranoid schizophrenia repeatedly uses profanity during an activity therapy session. Which response by the nurse would be most appropriate?
A. “Your behavior won’t be tolerated. Go to your room immediately.”
B. “You’re just doing this to get back at me for making you come to therapy.”
C. “Your cursing is interrupting the activity. Take time out in your room for 10 minutes.”
D. “I’m disappointed in you. You can’t control yourself even for a few minutes.”
Correct Answer: A. “Your behavior won’t be tolerated. Go to your room immediately.”
The nurse should set limits on client behavior to ensure a comfortable environment for all clients. The nurse should accept hostile or quarrelsome client outbursts within limits without becoming personally offended. Maintain a consistent approach, employ consistent expectations, and provide a structured environment. Clear and consistent limits and expectations minimize the potential for client’s manipulation of staff.
Option B: This is incorrect because it implies that the client’s actions reflect feelings toward the staff instead of the client’s own misery. Remain neutral as possible; Do not argue with the client. The client can use inconsistencies and value judgments as justification for arguing and escalating mania. Use a calm and firm approach; provide structure and control for a client who is out of control.
Option C: Redirect agitation and potentially violent behaviors with physical outlets in an area of low stimulation (e.g., punching bag). This can help to relieve pent-up hostility and relieve muscle tension. Decrease environmental stimuli (e.g., by providing a calming environment or assigning a private room); helps decrease the escalation of anxiety and manic symptoms.
Option D: Judgmental remarks may decrease the client’s self-esteem. Use short, simple, and brief explanations or statements. A short attention span limits understanding to small pieces of information. Chart, in nurse’s notes, behaviors; interventions; what seemed to escalate agitation; what helped to calm agitation; when as-needed (PRN) medications were given and their effect; and what proved most helpful.