A patient with schizophrenia tells the nurse as they sit in the day room, "I hear voices telling me bad things." The most therapeutic response the nurse can make is:
a. "Tell me what the voices are saying."
b. "I believe you hear voices, but I don't hear them myself."
c. "The voices are not real. They're a product of your imagination."
d. "Do you think the voices would go away if we went into your room to talk?"
ANS: B
By voicing his or her own reality related to the voices, the nurse does not deny the patient's experiences but helps the patient distinguish actual voices from those resulting from internal stimulation. Discussing what the voices are saying serves only to validate the reality of the voices. Challenging the voices will cause the patient to defend his perceptions and thereby reinforce the importance of the hallucination. Asking to move validates the reality of the voices and is not a helpful action since the voices go where the patient goes.
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