A patient with schizophrenia becomes increasingly agitated, clenches both fists and states, “I will hurt the person who laughs at me.” Which nursing action is the priority?
Correct answer: B. Approach calmly and arrange immediate safety measures
- A. Place the patient in a busy day-room activity
- B. Approach calmly and arrange immediate safety measures
- C. Argue that the threatened person has done nothing wrong
- D. Leave the patient alone until the anger has settled
Explanation
A specific threat with escalating agitation requires immediate attention to safety, using a calm approach and available risk-management measures. Arguing can increase hostility, and leaving the patient alone may fail to protect the patient or others.
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About Psychotic Disorders
Psychotic disorders involve disturbances in reality testing, including delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms. Coverage includes schizophrenia and related disorders, assessment of thought content and perception, risk management, antipsychotic treatment, and the distinction between psychosis, delirium, substance effects, and mood disorders.
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