Question

a young adult male client, diagnosed with paranoid schizophrenia, believes that world is trying to poison him. which intervention should the nurse include in this clients plan of care?

remind the client that his suspicions are not true.
ask one nurse to spend time with the client daily.
encourage the client to participate in group activities.
assign the client to a room closest to the activity room.

Explanation:

Analyze client symptoms and clinical needs

The client has paranoid schizophrenia and a persecutory delusion (believing the world is trying to poison him). Clients with persecutory delusions experience severe mistrust, suspicion, and fear of others. The primary nursing goal is to establish trust, minimize anxiety, and provide a safe, non-threatening environment.

Evaluate the intervention options

• Option 1: Challenging or directly refuting the delusion ("remind the client that his suspicions are not true") is non-therapeutic because it violates the client's reality, increases anxiety, and damages trust.
• Option 2: Assigning a consistent caregiver ("ask one nurse to spend time with the client daily") minimizes the number of new relationships the client must navigate, which helps build trust and reduces suspicion.
• Option 3: Encouraging group activities is inappropriate for a highly suspicious, paranoid client, as it can increase feelings of vulnerability and paranoia.
• Option 4: Placing the client near a high-traffic, noisy area like the activity room can overstimulate the client and exacerbate paranoid ideation.

Select the optimal therapeutic intervention

Assigning a consistent staff member (one nurse) to spend time with the client daily is the most effective intervention to foster a trusting relationship and reduce paranoia.

Answer:

• Remind the client that his suspicions are not true.
• Ask one nurse to spend time with the client daily. (Correct answer)
• Encourage the client to participate in group activities.
• Assign the client to a room closest to the activity room.