Question

On admission to the inpatient psychiatric unit, a client's facial expression indicates severe panic. The client repeatedly states, "I know the police are going to shoot me. They found out that I'm the child of the devil." What should the nurse say to initiate a therapeutic relationship with the client?

1. "You certainly look stressed. Can you tell me about the upsetting events that have occurred in your life recently?"
2. "Hello, my name is ___. I'm a nurse, and I'll care for you when I'm on duty. Should I call you ___, or do you prefer something else?"
3. "You're having very frightening thoughts. I'll help you find ways to cope with this scary thinking."
4. "Hello, ___. I'm going to be caring for you while I'm on duty. You look very frightened, but I'm sure you'll feel better by tomorrow."

Answer 1

The best statement a nurse can make to a client showing severe panic and delusional thoughts is one that conveys empathy, reassurance, and support, without validating the delusion.

Step-by-step explanation:

To initiate a therapeutic relationship with a client on an inpatient psychiatric unit who exhibits severe panic, it is essential to create an environment that conveys safety, understanding, and a willingness to help. The correct approach should involve acknowledging the client's distress and offering support and assistance. Among the choices provided, the best statement a nurse can make to start building a therapeutic relationship with the client expressing severe panic and delusional thoughts about being harmed by the police would be: "You're having very frightening thoughts. I'll help you find ways to cope with this scary thinking." This statement conveys empathy and reassurance, and it directly addresses the patient's immediate emotional experience without confirming or denying the delusion, thus helping to establish trust and rapport.