Schizophrenia Q 22
A client with schizophrenia tells the nurse he hears the voices of his dead parents. To help the client ignore the voices, the nurse should recommend that he:
A. Sit in a quiet, dark room and concentrate on the voices.
B. Listen to a personal stereo through headphones and sing along with the music.
C. Call a friend and discuss the voices and his feelings about them.
D. Engage in strenuous exercise.
Correct Answer: B. Listen to a personal stereo through headphones and sing along with the music.
Increasing the amount of auditory stimulation, such as by listening to music through headphones, may make it easier for the client to focus on external sounds and ignore internal sounds from auditory hallucinations. Work with the client to find which activities help reduce anxiety and distract the client from a hallucinatory material. Practice new skills with the client. If clients’ stress triggers hallucinatory activity, they might be more motivated to find ways to remove themselves from a stressful environment or try distraction techniques.
Option A: It would make it harder for the client to ignore the hallucinations. 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 C: Talking about the voices would encourage the client to focus on them. Keep to simple, basic, reality-based topics of conversation. Help the client focus on one idea at a time. Client’ thinking might be confused and disorganized; this intervention helps the client focus and comprehend reality-based issues.
Option D: This is incorrect because exercise alone wouldn’t provide enough auditory stimulation to drown out the voices. 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.