Psychiatric Medications Q 52
Nicolas is experiencing hallucinations and tells the nurse, “The voices are telling me I’m no good.” The client asks if the nurse hears the voices. The most appropriate response by the nurse would be:
A. “It is the voice of your conscience, which only you can control.”
B. “No, I do not hear your voices, but I believe you can hear them”.
C. “The voices are coming from within you and only you can hear them.”
D. “Oh, the voices are a symptom of your illness; don’t pay any attention to them.”
Correct Answer: B. “No, I do not hear your voices, but I believe you can hear them”.
The nurse, demonstrating knowledge and understanding, accepts the client’s perceptions even though they are hallucinatory. Accept the fact that the voices are real to the client, but explain that you do not hear the voices. Refer to the voices as “your voices” or “voices that you hear”. Validating that your reality does not include voices can help the client cast “doubt” on the validity of their voices.
Option A: Help the client to identify the needs that might underlie the hallucination. What other ways can these needs be met? Hallucinations might reflect needs for anger, power, self-esteem, and sexuality. Explore how the hallucinations are experienced by the client. Exploring the hallucinations and sharing the experience can help give the person a sense of power that he or she might be able to manage the hallucinatory voices.
Option C: Help the client to identify times that the hallucinations are most prevalent and frightening. Helps both nurse and client identify situations and times that might be most anxiety-producing and threatening to the client. Stay with clients when they are starting to hallucinate, and direct them to tell the “voices they hear” to go away. Repeat often in a matter-of-fact manner. The client can sometimes learn to push voices aside when given repeated instructions. especially within the framework of a trusting relationship.
Option D: Decrease environmental stimuli when possible (low noise, minimal activity). Decrease the potential for anxiety that might trigger hallucinations. Helps calm the client. Keep to simple, basic, reality-based topics of conversation. Help the client focus on one idea at a time. The client’s thinking might be confused and disorganized; this intervention helps the client focus and comprehend reality-based issues.