Question

A nurse in a mental health facility is caring for a client who has schizophrenia. Which of the following findings places the client at greatest risk for self-directed injury or injuring others?

Option 1: Social withdrawal and isolation
Option 2: Auditory hallucinations commanding harm
Option 3: Improved sleep patterns
Option 4: Increased interest in recreational activities

Answer 1

Auditory hallucinations commanding harm (Option 2) is the most concerning symptom for a client with schizophrenia, as it increases the risk for self-directed injury or injuring others.

Step-by-step explanation:

You asked which symptom places a client with schizophrenia at the greatest risk for self-directed injury or injuring others. Among the options provided, auditory hallucinations commanding harm (Option 2) is the most concerning. Auditory hallucinations that command a patient to harm themselves or others can be particularly dangerous. These hallucinations are a positive symptom of schizophrenia, meaning they are an excess or distortion of normal functions. These commanding voices can sometimes be so compelling that the individual feels pressured to act on them, which could result in self-directed injury or violence towards others.

Social withdrawal and isolation (Option 1) might raise concerns of possible depression or increased psychotic symptoms, but these symptoms alone do not directly suggest imminent risk of injury. Improved sleep patterns (Option 3) and an increased interest in recreational activities (Option 4) are generally positive signs and do not indicate an increased risk of harm.