Substance Abuse and Abuse Q 67
A client with paranoid thoughts refuses to eat because he believes the food has poisoned. The most appropriate initial action is to
A. Taste the food in the client’s presence.
B. Suggest that food be brought from home.
C. Simply state the food is not poisoned.
D. Inform the client he will be tube fed if he does not eat.
Correct Answer: C. Simply state the food is not poisoned.
This action presents reality. Interact with clients on the basis of things in the environment. Try to distract the client from their delusions by engaging in reality-based activities (e.g., card games, simple arts and crafts projects, etc). When thinking is focused on reality-based activities, the client is free of delusional thinking during that time. Helps focus attention externally.
Option A: Do not touch the client; use gestures carefully. Suspicious clients might misinterpret touch as either aggressive or sexual in nature and might interpret it as a threatening gesture. People who are psychotic need a lot of personal space. Show empathy regarding the client’s feelings; reassure the client of your presence and acceptance. The client’s delusion can be distressing. Empathy conveys your caring, interest, and acceptance of the client. Important clues to underlying fears and issues can be found in the client’s seemingly illogical fantasies.
Option B: Attempt to understand the significance of these beliefs to the client at the time of their presentation. Important clues to underlying fears and issues can be found in the client’s seemingly illogical fantasies. Recognize the client’s delusions as the client’s perception of the environment. Recognizing the client’s perception can help you understand the feelings he or she is experiencing.
Option D: Initially do not argue with the client’s beliefs or try to convince the client that the delusions are false and unreal. Arguing will only increase a client’s defensive position, thereby reinforcing false beliefs. This will result in the client feeling even more isolated and misunderstood.