Which observation during reassessment most suggests Sam is hearing voices?

Which observation during reassessment most suggests Sam is hearing voices?

• A. He pauses and mumbles to himself and tilts his head, then returns his attention.
• B. He smiles at the nurse.
• C. He looks away and remains silent.
• D. He sleeps.

Answer: (A)

Auditory hallucinations in schizophrenia often show up as a person reacting to voices only they can hear. In this reassessment, Sam’s pause, mumble to himself, and tilting of the head before he returns his attention signals that he’s trying to listen to something internal and is responding to it. That pattern—briefly engaging with unseen voices and then refocusing—fits the experience of hearing voices and staying in touch with an internal perceptual stimulus. Smiling at the nurse is a normal social cue and doesn’t point to internal voices. Looking away and staying silent could be disengagement or anxiety, not specifically a perceptual disturbance. Sleeping indicates rest or fatigue, not a hallucination.

Auditory hallucinations in schizophrenia often show up as a person reacting to voices only they can hear. In this reassessment, Sam’s pause, mumble to himself, and tilting of the head before he returns his attention signals that he’s trying to listen to something internal and is responding to it. That pattern—briefly engaging with unseen voices and then refocusing—fits the experience of hearing voices and staying in touch with an internal perceptual stimulus.

Smiling at the nurse is a normal social cue and doesn’t point to internal voices. Looking away and staying silent could be disengagement or anxiety, not specifically a perceptual disturbance. Sleeping indicates rest or fatigue, not a hallucination.