During an initial assessment, a patient becomes anxious and evasive when the nurse asks, "Have you ever heard voices when no one else was around?" The patient asks, "Why do you need to know that?" Select the nurse's best response
a. "Please be honest about these experiences," and repeat the question.
b. "Sometimes questions seem very personal, but we have our reasons for asking."
c. "What purpose do you think we might have in asking whether you hear voices?"
d. "I can see this subject makes you uncomfortable. We can discuss it another time."
D
The nurse should not try to pry information out of a patient who is reluctant to give the information. The nurse should note the patient's reaction to the question and carefully observe for behavioral signs that the patient may be experiencing auditory hallucinations.
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