A nurse is caring for a client who has schizophrenia and tells the nurse, "They lie about me all the time and they are trying to poison my food." Which of the following statements should the nurse make?

Choice A reason: This response acknowledges the client’s feelings without reinforcing the delusion. It demonstrates empathy and therapeutic communication, which is essential in managing schizophrenia. By validating the emotional experience rather than the delusional content, the nurse builds trust and reduces anxiety. This approach avoids confrontation and does not challenge the delusion directly, which could escalate agitation. Instead, it provides a supportive environment that encourages the client to express feelings safely. Choice B reason: Asking “Why do you think…” encourages the client to elaborate on the delusion, which can reinforce false beliefs. This line of questioning risks deepening the delusional thought process and may increase paranoia. It is not therapeutic because it focuses on the delusion rather than the client’s emotional state. Choice C reason: Telling the client they are mistaken directly challenges the delusion, which can cause defensiveness, mistrust, or agitation. Clients with schizophrenia often perceive such confrontation as invalidation of their reality, which can damage the therapeutic relationship. Choice D reason: Asking “Who is lying…” also reinforces the delusion by prompting the client to provide details. This validates the false belief and can worsen paranoia. It shifts focus away from emotional support and toward the delusional content, which is not therapeutic.