Answer to Question 1
C
Feedback: The client is asking for some type of validation, and the nurse's best response is to validate the client's pain as real. In the situation presented, the client's headaches are very real to him and he needs to talk out his feelings regarding what the physician said. It is inappropriate to give the client time to calm down or to say nothing. Answer D would put the client on the defensive.
Answer to Question 2
C
The nurse should prioritize the diagnosis risk for violence: directed toward others. A client who hears voices telling him to kill someone is at risk for responding and reacting to the command hallucination. Other risk factors for violence include aggressive body language, verbal aggression, catatonic excitement, and rage reactions.