A nurse is caring for a client who has paranoid schizophrenia and believes that they are being followed by FBI agents who are pretending to be psychiatric staff. Which of the following responses should the nurse make?

A. "Why do you feel the staff is the FBI”: Asking “why” can sound confrontational and may make the client feel interrogated or defensive. It can increase anxiety and does not provide emotional support. This approach is not therapeutic when a client is experiencing a fixed delusion. B. "The psychiatric staff is not FBI. They are here to help you.": Directly contradicting the client’s delusion can increase mistrust and agitation in a client with paranoid schizophrenia. This response challenges the belief without acknowledging the client’s emotional experience, which can damage rapport. C. "This must be very frightening for you, let's talk more about it.": This response acknowledges the client’s feelings without validating the delusion itself. It conveys empathy, reduces anxiety, and encourages further communication. This therapeutic approach helps build trust while gently redirecting focus to the client’s emotional state. D. "What makes you think the staff is following you”: Although more open-ended than option A, this question encourages the client to further elaborate on the delusion. It risks reinforcing the false belief rather than focusing on emotional support and reality-based care.