HP CHO -9 October 2022
Psychiatric Nursing
Easy
A client expresses the belief that armed forces are out to kill him. This is an example of:
Appeared in: HP CHO -9 October 2022
Explanation
- A delusion is a fixed, false belief that is resistant to reason or evidence.
- A delusion of persecution specifically involves the belief that one is being threatened, plotted against, or is in danger of being harmed by others.
- The client's belief that a powerful entity (armed forces) intends to kill him is a textbook presentation of a persecutory delusion.
- This type of delusion is common in psychotic disorders like schizophrenia.
Why Other Options Were Wrong
- Option A: Hallucinations are false sensory perceptions (e.g., hearing voices, seeing things that aren't there). The client is describing a false belief (a thought), not a sensory experience.
- Option B: A delusion of infidelity (or morbid jealousy) is the specific false belief that one's partner is being unfaithful. This does not match the client's stated fear.
- Option C: Derealization is a feeling of detachment from one's surroundings, where the world seems unreal, foggy, or dream-like. It is a disturbance of perception, not a specific, organized belief about a threat.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of types of delusions in psychiatric nursing as background academic context rather than a clinical decision trigger.
- A nurse's primary responsibility when caring for a client with persecutory delusions is to ensure the safety of the client and others. The client's fear may cause them to act defensively or aggressively.
- It is crucial to build a trusting therapeutic relationship. Directly confronting or arguing about the delusion is counterproductive and will likely increase the client's anxiety and mistrust.
- What if? If the client's delusion was that their food was poisoned (another form of persecution), the nursing priority would be to address nutritional needs while ensuring safety. This might involve using pre-packaged foods or allowing the client to observe food preparation to reduce fear.
How to Approach the Question
- First, analyze the client's statement: 'armed forces are out to kill him'. Identify the core nature of the symptom. Is it a thought, a feeling, or a sensory experience?
- Recognize that the statement represents a belief or a thought, not a sensory perception. This helps to differentiate it from hallucinations.
- Next, evaluate the content of the belief. The theme is being targeted for harm by an external group ('armed forces').
- Review the definitions of the options. 'Delusion of persecution' is defined as a belief of being harmed or conspired against.
- Match the client's statement to the correct definition. The fear of being killed by the armed forces directly aligns with the definition of a delusion of persecution.
Concept Tested & Keywords
- Concept Tested: Identification of types of delusions in psychiatric nursing.
- Stem keywords: client, belief, armed forces, kill him
- Lead-in keywords: example of
- Clinical cues: The client's statement 'armed forces are out to kill him' is a direct expression of a persecutory thought.
Question ID
Q5_pshzCO1M_9caqUSHXOa
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. 3802-3804, 3250-3252, 4723-4725
Practise the full HP CHO -9 October 2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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