A nurse is developing a plan of care for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following actions should the nurse include in the plan?

A. Avoid eye contact with the client: Avoiding eye contact can convey disinterest or disengagement, which may increase the client’s sense of isolation. Therapeutic engagement requires maintaining appropriate eye contact to promote trust and effective communication. B. Encourage the client to lie down in a quiet room: Isolating the client in a quiet room may intensify auditory hallucinations, as there are fewer environmental stimuli to help the client reality-test. Structured interaction and distraction techniques are generally more effective. C. Ask the client directly what they are hearing: Engaging the client in a nonjudgmental discussion about their hallucinations helps the nurse understand the content, assess risk, and provide support. This approach promotes reality orientation, therapeutic rapport, and early identification of command hallucinations that may pose safety risks. D. Refer to the hallucinations as if they are real: Validating hallucinations as real can reinforce psychotic thinking and perpetuate the hallucinations. The nurse should acknowledge the client’s experience without confirming the reality of the voices.