NCLEX · Mental Health Disorders

A client with schizophrenia tells the nurse: 'The government has planted a device in my spine to monitor my thoughts.' What type of delusion is this?

Correct answer

Persecutory/paranoid — the belief that an external force is controlling, monitoring, or persecuting the client; this is the most common type of delusion in schizophrenia

  1. A Grandiose
  2. B Persecutory/paranoid — the belief that an external force is controlling, monitoring, or persecuting the client; this is the most common type of delusion in schizophrenia
  3. C Somatic
  4. D Erotomanic

Why this is the answer

TYPES OF DELUSIONS: PERSECUTORY (most common in schizophrenia): Belief that someone or something is spying on, persecuting, or plotting against the client ('the government is monitoring me', 'my food is poisoned', 'I'm being followed'); GRANDIOSE: Belief that the client has special powers, status, or identity ('I am actually the messiah', 'I discovered the cure for all disease'); SOMATIC: False beliefs about the body ('I have insects living in my blood', 'my organs are rotting'); EROTOMANIC: Belief that someone (often a public figure) is in love with the client; REFERENTIAL: Belief that external events (TV, newspaper) have special personal meaning; THERAPEUTIC APPROACH TO PERSECUTORY DELUSIONS: Do not argue or try to convince the client the belief is false — this increases agitation and distrust; do not pretend to believe the delusion; acknowledge the client's emotional experience ('I can see this is very frightening/distressing for you'); refocus on here-and-now and safety; administer antipsychotics as prescribed (dopamine blocking agents are the primary treatment).
Source: NCLEX-RN Test Plan: Psychosocial — Schizophrenia, Types of Delusions

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