NVS Staff Nurse - 2019
Mental Health Nursing
Easy
A 40-year-old client is admitted with the diagnosis of delusions of grandeur. Which of the following option supports this diagnosis?
Appeared in: NVS Staff Nurse - 2019
Explanation
- Delusions of grandeur (or grandiose delusions) are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful.
- The option describing a belief of being 'highly, famous and important' is a direct and classic manifestation of a grandiose delusion.
- This type of delusion is a fixed, false belief that is inconsistent with the individual's reality and cultural background.
Why Other Options Were Wrong
- Option A: This describes a delusion of guilt or sin, where the individual feels responsible for a terrible event or action. It is related to worthlessness, not exaggerated self-importance.
- Option B: This describes a persecutory delusion, which involves the belief that one is being targeted for harm. It is based on fear and suspicion, not a sense of superiority.
- Option C: This describes a delusion of reference, where a person believes that unrelated events or people are personally significant. It involves misinterpreting neutral stimuli, not a belief in one's own greatness.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Identification of specific types of delusions, particularly delusions of grandeur to guide bedside assessment, documentation, and the next nursing action.
- Nurses must be able to identify different types of delusions to assess the client's thought content accurately and plan appropriate interventions.
- When interacting with a client experiencing delusions, it is crucial to not challenge the belief directly, as this can increase agitation and damage the therapeutic relationship. Instead, focus on the feelings behind the delusion and orient the client to reality.
- What if the client's delusion was persecutory (e.g., 'the nurses are trying to poison me')? The immediate nursing priority would shift to ensuring safety (both the client's and staff's), building trust through consistent and transparent actions, and possibly involving security if there is a risk of aggression.
How to Approach the Question
- First, identify the key term in the question stem: 'delusions of grandeur'.
- Define this term based on your knowledge. Grandeur relates to a false belief of being very important, powerful, or famous.
- Systematically evaluate each option against this definition.
- Option A ('responsible for evil') is about guilt, not grandeur.
- Option B ('being killed') is about persecution, not grandeur.
- Option C ('connected to unrelated client') is about reference, not grandeur.
Concept Tested & Keywords
- Concept Tested: Identification of specific types of delusions, particularly delusions of grandeur.
- Stem keywords: delusions of grandeur, diagnosis
- Lead-in keywords: supports this diagnosis
- Clinical cues: 40-year-old client
- Negative lead-in flag: false
Question ID
QZGcPzoccr1Fz_VI_N8wM2
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 3807-3809, 4723-4725, 3803-3805
Practise the full NVS Staff Nurse - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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