A client on a psychiatric unit with paranoid personality disorder refused to eat breakfast because they believe the day shift nurse is poisoning the food. After the treatment regimen is updated, which assessment finding indicates effectiveness?

• A. The client eats breakfast without complaint
• B. The client reports less paranoia
• C. The client no longer says the nurse is poisoning the food
• D. The client sleeps better

Answer: (C)

The key idea is that improvement in paranoid personality disorder is shown by a reduction or resolution of persecutory thinking. If the client no longer says the nurse is poisoning the food, that directly demonstrates the specific paranoid belief has diminished, which is the core symptom being targeted by treatment. While eating breakfast without complaint, reporting less paranoia in general, or sleeping better might reflect some overall improvement, they do not provide concrete evidence that the persecutory delusion has resolved. The absence of the poisoning belief is the clearest indicator that the treatment is addressing the main symptom.