A nurse collects data from a client with schizophrenia. Which statement indicates the client is experiencing a command hallucination?

• A. Can you see these spiders crawling all over me?
• B. Are you planning to kill me?
• C. The aliens are going to abduct me tonight.
• D. The voices told me to quit eating the food here

Answer: (D)

Command hallucinations occur when a person hears voices that give explicit orders to perform or avoid a specific action. This is especially important in schizophrenia because following such commands can put the person at risk. The statement “The voices told me to quit eating the food here” shows a direct directive from an internal voice, which is the hallmark of a command hallucination. The other examples reflect different symptom types: a tactile hallucination (spiders crawling on the body), a delusional or paranoid belief (aliens will abduct me), and a questioning of someone’s intent (Are you planning to kill me?), none of which involve an external command to act.