A nurse is collecting data from a client who has schizophrenia. Which of the following client statements indicates that the client is experiencing a command hallucination?

A. This is a crucial first step in recovery. It involves recognizing and accepting that one has lost control over their drinking and that alcohol use is causing negative consequences in their life. Without acknowledging this lack of control, individuals may not be motivated to seek or engage in treatment.
B. While medications such as disulfiram (Antabuse) or naltrexone (Revia) can be part of a comprehensive treatment plan for alcohol use disorder, agreeing to a prescription for an alcohol use deterrent is not typically the first step in recovery. It usually follows assessment, acknowledgment of the problem, and development of a treatment plan in collaboration with healthcare providers.
C. Building a strong support network is indeed crucial for long-term recovery. This network may include family, friends, peers in recovery, and support groups like Alcoholics Anonymous (AA). However, forming this support network is often a step that occurs as part of ongoing treatment and recovery efforts rather than the very first step.

D. Incorporate a form of spirituality into daily life: Spirituality or a sense of purpose can be a significant component of recovery for some individuals, providing strength and motivation. However, it is not universally considered the first step in recovery. Spirituality may be explored and integrated into the recovery journey as individuals progress in treatment and self-discovery.

A. This option is not appropriate for a client with acute delirium. Delirium is characterized by fluctuating levels of consciousness, attention, and cognition. High-stimulation environments, such as loud noises or bright lights, can exacerbate confusion and agitation in these clients. Therefore, providing a calm and quiet environment is crucial to help reduce symptoms of delirium.
B. Delirium can often be worsened during nighttime due to factors like disruption of sleep-wake cycles and disorientation in a new environment. Keeping the client's room dark at night helps to promote rest and reduce disturbances. However, this is not the most important intervention.

C. Family support and presence are typically beneficial for clients, even those with delirium. Family members can provide familiarity, comfort, and assistance in reorienting the client. Discouraging visitation would not be appropriate unless the family members are contributing to increased agitation or confusion. Instead, it's important to educate family members on how to interact with and support the client effectively.
D. Clients with delirium often experience impaired cognition, making decision-making challenging for them. Limiting the client's need to make decisions can help reduce their stress and frustration. It's important for the nurse to simplify choices when possible and provide guidance and support as needed. This approach can help alleviate cognitive load and improve the client's ability to cope.