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    HESI PN Exit 2023 Proctored Exam

    A client with delusions tells the nurse, "You aren't doing your job. Go get those people over there and shoot them before they get me." Which statement is the nurse's best response?

    Explanation & Rationale

    The correct answer is choice B. “You seem quite frightened right now.”. Choice A rationale: While reassuring the client that no one will hurt them is well-intentioned, it may not effectively address the client’s immediate emotional state or validate their feelings. Choice B rationale: Acknowledging the client’s fear helps validate their emotions and opens a pathway for further therapeutic communication. It shows empathy and understanding, which can help build trust and provide comfort. Choice C rationale: Telling the client they are in a safe place is reassuring, but it may not fully address the client’s immediate emotional distress or validate their feelings. Choice D rationale: Asking the client what they would like the nurse to do to protect them might reinforce the delusion and could potentially escalate the situation. It is more effective to acknowledge the client’s feelings and provide reassurance.

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