A nurse is monitoring a client who is receiving haloperidol. Which of the following findings is the priority to report to the provider?

Choice A reason: A client who is hearing command hallucinations should be prioritized first because command hallucinations can be particularly dangerous. These hallucinations can involve voices instructing the client to harm themselves or others. Immediate assessment and intervention are crucial to ensure the client's safety and to prevent potential harm. The nurse needs to address the client's safety concerns and implement necessary precautions.

Choice B reason: A client verbalizing ideas of reference, which involve misinterpreting events or remarks as having personal significance, may experience distress and paranoia. While these symptoms require attention and management, they do not typically pose an immediate risk to the client's or others' safety. The nurse should monitor and support the client but prioritize more urgent safety concerns first.

Choice C reason: A client using neologisms, or creating new words that are not understood by others, indicates a thought disorder. While this is a significant symptom that requires intervention, it does not typically pose an immediate risk to safety. The nurse should evaluate the client's communication and thought processes and provide appropriate care.

Choice D reason: A client demonstrating clang associations, which involve linking words based on sound rather than meaning, also indicates a thought disorder. This symptom requires attention, but it does not usually pose an immediate threat to the client's or others' safety. The nurse should assess the client's condition and provide appropriate interventions but prioritize more urgent safety concerns first.

Choice A reason: This response does not address the client's immediate fear and hallucination. While it is important to collect the blood specimen as ordered, the nurse should first address the client's hallucination and provide reassurance. Simply stating that the provider requires the blood specimen may not reduce the client's anxiety or confusion.

Choice B reason: Telling the client they must be mistaken is dismissive of their experience. Clients experiencing hallucinations perceive them as real, and dismissing these perceptions can increase their distress and mistrust. Instead, the nurse should acknowledge the client's feelings and provide comfort without invalidating their experience.

Choice C reason: Stating that the nurse is using a syringe and not a snake may not be helpful, as the client is experiencing a hallucination and may not be able to distinguish between reality and their perception. This response does not validate the client's feelings or provide the necessary reassurance.

Choice D reason: Acknowledging the client's hallucination and expressing empathy is the most appropriate response. By saying, "I don't see a snake, but that must be scary for you," the nurse acknowledges the client's fear and provides comfort without reinforcing the hallucination. This approach helps build trust and rapport, making it easier to proceed with the necessary procedure while ensuring the client's emotional well-being.