Question

a male client with schizophrenia tells the nurse that the voices he hears are saying, \you must kill yourself.\ to assist the client in coping with these thoughts, which response is best for the nurse to provide?

• tell yourself that the voices are unreasonable.
• exercise when you hear the voices.
• talk to someone when you hear the voices.
• the voices arent real, so ignore them.

Explanation:

Analyze the clinical scenario and safety risk

The client is experiencing command auditory hallucinations ("You must kill yourself"), which present an immediate safety risk. Coping strategies for auditory hallucinations should focus on active, reality-based distraction and seeking interpersonal support to reduce isolation and reinforce safety.

Evaluate the intervention options

• "Tell yourself that the voices are unreasonable" and "The voices aren't real, so ignore them" are cognitive strategies that are often ineffective during acute command hallucinations, as they attempt to argue with or dismiss the client's immediate perception of reality.
• "Exercise when you hear the voices" is a physical distraction but does not address the immediate safety risk or provide interpersonal support.
• "Talk to someone when you hear the voices" is a highly effective, reality-oriented coping mechanism. Interacting with a real person helps distract the client from the voices, anchors them in reality, and provides an immediate avenue to seek help if the commands become overwhelming.

Determine the best nursing response

Encouraging the client to seek out and talk to a trusted person or staff member when hearing command hallucinations is the safest and most effective behavioral coping strategy.

Answer:

• Tell yourself that the voices are unreasonable.
• Exercise when you hear the voices.
• Talk to someone when you hear the voices. (Correct answer)
• The voices aren't real, so ignore them.