Question

a 38-year-old female client is admitted with a diagnosis of paranoid schizophrenia. when her tray is brought to her, she refuses to eat and tells the nurse, \i know you are trying to poison me with that food.\ which response is best for the nurse to make?

• ill leave your tray here. i am available if you need anything else.
• youre not being poisoned. why do you think someone is trying to poison you?
• no one on this unit has ever died from poisoning. youre safe here.
• i will talk to your healthcare provider about the possibility of changing your diet.

Explanation:

Analyze the client's behavior and underlying psychiatric condition

The client has paranoid schizophrenia and is experiencing a persecutory delusion ("I know you are trying to poison me with that food").

Evaluate therapeutic communication principles for delusional clients

• Arguing, challenging, or asking "why" questions reinforces or focuses too much on the delusion.
• Attempting to logically disprove the delusion is ineffective because delusions are fixed, false beliefs.
• Offering to change the diet validates the delusion by implying there is indeed something wrong with the food.
• Leaving the tray while offering availability is non-threatening, avoids power struggles, allows the client time to feel safe, and maintains a therapeutic presence.

Answer:

• (A) I'll leave your tray here. I am available if you need anything else. (Correct answer)
• (B) You're not being poisoned. Why do you think someone is trying to poison you?
• (C) No one on this unit has ever died from poisoning. You're safe here.
• (D) I will talk to your healthcare provider about the possibility of changing your diet.