A client tells nurse that television newscaster is sending a secret message to her. The nurse suspects client is experiencing:

Correct Answer: C. Ideas of reference

Ideas of reference refers to the mistaken belief that neutral stimuli have special meaning to the individual such as the television newscaster sending a message directly to the individual. In people with bipolar disorder, mania and hypomania can comprise various symptoms, from reckless spending to sexual promiscuity. In addition, some more subtle symptoms may also occur, such as the belief held by some patients that everything occurring around them is related somehow to them when in fact it isn’t. This symptom is known as ideas of reference.

• Option A: A delusion is a false belief. Delusions are defined as fixed, false beliefs that conflict with reality. Despite contrary evidence, a person in a delusional state can’t let go of their convictions. Delusions are often reinforced by the misinterpretation of events. Many delusions also involve some level of paranoia. For example, someone might contend that the government is controlling our every move via radio waves despite evidence to the contrary.
• Option B: Flight of ideas is a speech pattern in which the client skips from one unrelated subject to another. A nearly continuous flow of accelerated speech with abrupt changes from topic to topic that are usually based on understandable associations, distracting stimuli, or plays on words. When severe, speech may be disorganized and incoherent. It is part of the DSM -5 criteria for Manic episodes.
• Option D: A hallucination is a sensory perception, such as hearing voices and seeing objects, that only the client experiences. Hallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind. Common hallucinations can include feeling sensations in the body, such as a crawling feeling on the skin or the movement of internal organs; hearing sounds, such as music, footsteps, windows or doors banging; hearing voices when no one has spoken (the most common type of hallucination). These voices may be positive, negative, or neutral. They may command someone to do something that may cause harm to themselves or others.