When a paranoid schizophrenia client stops mid-sentence and tilts his head as if listening to something, what is the most appropriate intervention?

When a paranoid schizophrenia client stops mid-sentence and tilts his head as if listening to something, what is the most appropriate intervention?

• A. Call and report the behavior to the physician.
• B. Give a PRN dose of Ativan IM.
• C. Ask, 'What are the voices saying to you?'
• D. State, 'Well, I see you are distracted right now. We'll talk more later.'

Answer: (C)

When a client with paranoid schizophrenia shows signs of auditory hallucinations, the best move is to acknowledge the experience and invite them to describe what they are hearing. Asking, “What are the voices saying to you?” opens the conversation in a nonjudgmental way, validates the patient’s experience, and provides essential information about the hallucination's content, intensity, and potential risk. This approach helps build rapport and safety: it shows you’re accepting and curious rather than dismissive, which can reduce fear and resistance and guide further assessment and interventions. If the voices are commanding harm or urging self-harm, you can then assess safety and implement appropriate steps. Choosing to report to the physician immediately without first connecting with the patient misses the opportunity to understand the current experience and risks. Giving a PRN sedative like Ativan addresses agitation but not the underlying hallucinations and can obscure symptoms or lead to dependency. Saying the patient is distracted minimizes their distress and undermines trust.

When a client with paranoid schizophrenia shows signs of auditory hallucinations, the best move is to acknowledge the experience and invite them to describe what they are hearing. Asking, “What are the voices saying to you?” opens the conversation in a nonjudgmental way, validates the patient’s experience, and provides essential information about the hallucination's content, intensity, and potential risk.

This approach helps build rapport and safety: it shows you’re accepting and curious rather than dismissive, which can reduce fear and resistance and guide further assessment and interventions. If the voices are commanding harm or urging self-harm, you can then assess safety and implement appropriate steps.

Choosing to report to the physician immediately without first connecting with the patient misses the opportunity to understand the current experience and risks. Giving a PRN sedative like Ativan addresses agitation but not the underlying hallucinations and can obscure symptoms or lead to dependency. Saying the patient is distracted minimizes their distress and undermines trust.