A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?

Correct Answer: C

Rationale: The correct answer is C because it demonstrates empathy and validates the patient's feelings without agreeing with the delusion. By acknowledging the patient's fear, the nurse can establish trust and rapport, which are crucial in therapeutic communication. This response shows understanding and compassion, helping to de-escalate the situation and provide a supportive environment for the patient. Choice A is incorrect as it denies the patient's belief and may lead to increased agitation. Choice B is incorrect as it challenges the patient's delusion, which can worsen the situation and lead to further confrontation. Choice D is incorrect as it dismisses the patient's feelings and may cause the patient to become defensive or feel misunderstood.

Correct Answer: C

Rationale: The correct answer is C: Olanzapine (Zyprexa). Olanzapine is an atypical or second-generation antipsychotic that is effective in treating both positive and negative symptoms of schizophrenia. It also has a lower risk of causing extrapyramidal symptoms like muscle stiffness and motor restlessness compared to typical antipsychotics like haloperidol. Chlorpromazine (A) is a typical antipsychotic with similar side effects as haloperidol. Clozapine (B) is an atypical antipsychotic that is effective for treatment-resistant schizophrenia but is usually considered as a last resort due to its potential for serious side effects. Fluoxetine (D) is an antidepressant and not typically used as a first-line treatment for schizophrenia.

Correct Answer: C

Rationale: The correct answer is C because it emphasizes the importance of developing trust and rapport with the patient before addressing their delusions. By using empathy and calmness, the nurse can create a safe environment for the patient to feel understood and supported. This approach can help the patient be more receptive to feedback about the discrepancies in their thinking. Choice A is incorrect because simply giving the patient something to think about may not address the underlying issues causing the delusions. Choice B is incorrect as it assumes the patient will view the nurse negatively, which may not always be the case. Choice D is incorrect as it suggests going along with the patient's delusions, which can potentially reinforce and perpetuate their false beliefs.

Correct Answer: A

Rationale: Correct Answer: A Rationale: A: Asking about trust in the nurse is not immediately relevant as the patient's primary concern is the change in voice content. Building trust is important but addressing the content of hallucinations takes priority. B: This is relevant as commanding voices could pose a safety risk. C: Monitoring frequency helps assess severity and response to treatment. D: Understanding triggers for hallucinations is important for managing symptoms.

Correct Answer: B

Rationale: The correct answer is B: Agnosis - inability to recognize familiar objects or people. This is because the client's inability to recognize formerly familiar objects and people in his environment aligns with the definition of agnosis. Affect (choice A) refers to experienced feelings and emotions, which is not the issue described in the question. Apraxia (choice C) is difficulty carrying out purposeful tasks, not related to recognition of objects or people. Anhedonia (choice D) is a lack of pleasure, which is also not applicable to the client's situation. Therefore, the best fit for the client's experience is agnosis.