Schizophrenia Q 20
A client with a diagnosis of paranoid schizophrenia comments to the nurse, “How do I know what is really in those pills?” Which of the following is the best response?
A. Say, “You know it’s your medicine.”
B. Allow him to open the individual wrappers of the medication.
C. Say, “Don’t worry about what is in the pills. It’s what is ordered.”
D. Ignore the comment because it’s probably a joke.
Correct Answer: B. Allow him to open the individual wrappers of the medication.
This is correct because allowing a paranoid client to open his medication can help reduce suspiciousness. Talk openly with the client about their beliefs and thoughts, showing empathy and support. Help build trust and rapport with clients. Paranoid clients may be more reluctant to trust anyone, but open communication generally offers more cooperation. Explain all procedures clearly and carefully, and their purpose, before starting them. Prevents aggressive behavior and suspicion. Promotes cooperation and compliance. Helps develop trust.
Option A: This is incorrect because the client doesn’t know that it’s his medication and he’s obviously suspicious. Discuss feelings and help the client identify behaviors that cause conflict or alienate others. Helping clients see the reality of their behaviors can help treatment progress and lead to more appropriate behaviors and interactions.
Option C: Discuss and have the client demonstrate (through role-play if appropriate) more acceptable responses and reactions to behaviors and stressors. Helps the client develop more positive coping skills for dealing with delusions, suspicions, and fears. Provide reorientation as appropriate, but avoid confrontation of the delusions. The client may need to be refocused to reality at times, but avoid confrontation that may be interpreted as argumentative to avoid non-compliance and uncooperative behaviors.
Option D: Telling the client not to worry or ignoring the comment isn’t supportive and doesn’t offer reassurance. Set behavior boundaries and enforce per facility protocols with medications or restraints as necessary. Promote the safety of clients during agitated moments and the safety of others from aggressive behaviors. Follow your facility’s specific protocol regarding supervision, restraint, and documentation.