When a client reports hearing voices, what is the most appropriate initial response by the nurse?

When a client reports hearing voices, the most appropriate initial response by the nurse is to ask what the voices are saying to them. This approach demonstrates active listening and acknowledges the client's experience. By asking this question, the nurse opens a dialogue that allows the client to express their feelings and thoughts about the hallucinations. It also provides the nurse with important information about the content and nature of the voices, which can be crucial for assessment and determining the best course of care.

Engaging with the client's experience in this manner can help build trust and rapport, which is essential in therapeutic relationships. Additionally, understanding the specifics of what the client is hearing may inform the nurse about the severity of the client's symptoms and their safety.

The other choices, while potentially relevant in future interactions, do not directly address the client's immediate experience. A statement about not hearing anyone but the client may dismiss their feelings and invalidate their experience. Commenting on the client’s body language does not engage with their report of hearing voices, and discussing anxiety might not be pertinent at the moment when the primary focus should be on the auditory hallucinations.