A patient with schizophrenia tells the nurse as they sit in the ...

[KWilfred]

A patient with schizophrenia tells the nurse as they sit in the day room, I hear voices telling me bad things. The most therapeutic response the nurse can make is:
 
  a. Tell me what the voices are saying.
  b. I believe you hear voices, but I don't hear them myself.
  c. The voices are not real. They're a product of your imagination.
  d. Do you think the voices would go away if we went into your room to talk?

Question 2

A patient tells the nurse, When I'm in the day room, I hear people whispering about me, and that makes me want to punch them. What direction will the nurse provide the staff regarding interacting with this patient?
 
  a. To minimize the need to whisper, utilize nonverbal techniques when possible.
  b. Stay physically close to this patient and use touch as a tool to interact with him.
  c. Treat this patient matter-of-factly. Be direct; don't talk about him or others in his presence.
  d. Interact with this patient only when necessary. The fewer interactions, the fewer misinterpretations there will be.

[af]

Answer to Question 1

ANS: B
By voicing his or her own reality related to the voices, the nurse does not deny the patient's experiences but helps the patient distinguish actual voices from those resulting from internal stimulation. Discussing what the voices are saying serves only to validate the reality of the voices. Challenging the voices will cause the patient to defend his perceptions and thereby reinforce the importance of the hallucination. Asking to move validates the reality of the voices and is not a helpful action since the voices go where the patient goes.

Answer to Question 2

ANS: C
This approach is important when providing care for a patient who is misinterpreting reality and is suspicious of the motives of others. Ostracizing the patient is non-therapeutic. Patients often misinterpret touch as threatening. This might promote loss of control. Using nonverbal communication techniques would be nontherapeutic as it would increase patient anxiety and promote loss of control.