A client with schizophrenia says, "Voices are arguing about me again." Which response should the nurse make?
1I do not hear the voices, but I know this is distressing; what are they saying to you?✓ Correct answer
2Try to ignore the voices and join the group without discussing what you hear
3Think about what you may have done that caused the voices to start arguing
4I understand. many clients with your diagnosis experience the same thing.
Explanation
The nurse acknowledges the distress without confirming the hallucination, states reality, and assesses the voice content for safety. Command content or threats require immediate risk evaluation and protective action.
Quick answer Present reality, validate the client's distress, and assess exactly what the voices are saying.
Why this is correct A therapeutic response neither agrees that the voices are external nor shames the client for hearing them. Asking about content identifies commands, threats, or escalating risk and helps the nurse plan immediate safety support.
Easy analogy or mental picture The nurse stands on solid ground while asking what the client's internal alarm is reporting. The analogy highlights reality and assessment but does not suggest that hallucinations are voluntary or unimportant.
NCLEX decision rule When a client reports hallucinations, state your own reality without arguing, acknowledge the emotion, and assess content and intent. Treat command hallucinations or threats as a direct safety concern.
Why the other choices are wrong Ignoring the report misses risk assessment. Blaming the client increases shame, and assuming voices cannot direct harmful behavior falsely minimizes possible command content.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing