Nurse Ron enters a client’s room, client says, “They’re crawling on my sheets! Get m off my bed!” Which of following assessments is most accurate?

Correct Answer: D. The client is experiencing visual hallucination

The presence of a sensory stimulus correlates with the definition of a hallucination, which is a false sensory perception. Visual hallucinations involve seeing things that aren’t there. The hallucinations may be of objects, visual patterns, people, or lights. Hallucinations, defined as the perception of an object or event (in any of the 5 senses) in the absence of an external stimulus, are experienced by patients with conditions that span several fields (e.g., psychiatry, neurology, and ophthalmology). When noted by nonpsychiatrists, visual hallucinations, one type of sensory misperception, often trigger requests for psychiatric consultation, although visual hallucinations are not pathognomonic of a primary psychiatric illness.

• Option A: Aphasia refers to a communication problem. Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to injury to the brain-most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections.
• Option B: Dysarthria is a difficulty in speech production. Dysarthria is a motor speech disorder in which the muscles that are used to produce speech are damaged, paralyzed, or weakened. The person with dysarthria cannot control their tongue or voice box and may slur words. Motor speech disorders like dysarthria result from damage to the nervous system. Many neuromuscular conditions (diseases that affect the nerves controlling certain muscles) can result in dysarthria. In dysarthria, the muscles used to speak become damaged, paralyzed, or weakened.
• Option C: Flight of ideas is rapidly shifting from one topic 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.