Mental Health Chapter 15

The nurse is discharging a client with a diagnosis of obsessive-compulsive disorder (OCD) following a lengthy inpatient hospitalization. Further teaching is necessary when the client makes which statement?

"I am relieved to be better and shouldn't need to do all this again."

What question by the nurse is focused on identifying oniomaniac tendencies in a client diagnosed with depression?

"Do you get enjoyment out of all the clothes you buy?"

A client checks and rechecks the lock on the door five times before leaving home. What statement by the client indicates that this behavior is a result of obsessive-compulsive disorder (OCD)?

"I check until my anxiety subsides."

The nurse is providing education to a client prescribed clomipramine to help with obsessive-compulsive disorder. Which statement by the client indicates the teaching was effective?

"I may have a risk of suicidal thoughts with the medication."

The nurse provides care to a client who is diagnosed with body dysmorphic disorder (BDD). Which client statement indicates a need for the nurse to include risk for suicide into the client's plan of care?

"I was diagnosed with substance use disorder last year and I still struggle with it."

The community health nurse assesses an older adult client who reports "I've started praying all the time; it helps me with my worries." The client tells the nurse that they must have e disorder after reading articles online. Which would be the nurse's best response?obsessive-compulsiv

"If you are concerned, I would recommend you discuss this with a psychiatrist."

The nurse is discussing treatment of body dysmorphic disorder (BDD) with a client. The client asks the nurse whether surgery is an option. What is the best therapeutic response to the client's concern?

"It sounds like this is distressing for you; how do you think surgery might help?"

Which statement made by the nurse to the family of a client diagnosed with obsessive-compulsive disorder (OCD) demonstrates the best general understanding of the chronic nature of the disorder and its management?

"It's important to know that the symptoms will intensify during periods of stress."

A nurse is teaching a group of clients about obsessive-compulsive disorder. Which statement made by a client would indicate a need for further teaching?

"Obsessive-compulsive disorder is a short-term illness with a sudden onset while the person is stressed."

The nurse provides an education session on the topic of obsessive-compulsive disorder. The nurse knows the teaching has been effective when a participant makes which statement?

"To be diagnosed, your symptoms interfere with your life, work, and friends."

Which client is most likely to be diagnosed with body dysmorphic disorder (BDD)?

A client who firmly believes that everyone who sees the client fixates on the size of the client's ears

The client has begun to wash the hands every hour due to the fear of germs becoming embedded in the client's skin leading the client to develop cancer. The nurse interprets this behavior as indicating which condition?

A compulsion

The mental health nurse explains that the difference between an obsession and a compulsion can correctly be identified as what?

A compulsion involves repeating a seemingly purposeful action.

How does the nurse help to decrease anxiety and build confidence in a client with obsessive-compulsive disorder?

Help the client find alternative methods to deal with anxiety.

What intervention does the nurse perform to assist the client in decreasing the frequency of repetitive behaviors?

Assist the client to keep a record of when time is used in performing activities.

The nurse is assisting a client with behavior therapy for obsessive-compulsive disorder (OCD). What intervention does the nurse implement for the client during exposure?

Assists the client to confront situations.

A psychiatric-mental health nurse is conducting an educational session for families of clients diagnosed with obsessive-compulsive disorder (OCD). What component(s) should the nurse teach the families of clients diagnosed with OCD? Select all that apply.

Avoid giving advice such as, "just think of something else." Be patient with your family member's discomfort. Monitor your own anxiety and take a break if needed.

The nurse is assessing a client who wants an amputation of the client's healthy left arm. The client feels that the left arm "does not belong" to the body and it feels unnatural. What condition does the nurse identify in this client?

Body identity integrity disorder

A client with obsessive-compulsive disorder (OCD) is preparing for exposure and response prevention behavioral therapy. What does the nurse recommend as the first step?

Chronicle situations that trigger obsessions.

A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?

Compulsion

The nurse is assessing a client recently diagnosed with obsessive-compulsive disorder (OCD). What does the nurse tell the client about the onset of the disorder?

Early onset may indicate family history of OCD.

A client with obsessive-compulsive disorder (OCD) is being discharged from the health care facility. What does the nurse teach the client and the family?

Encourage the client to participate in follow-up therapy.

Which medication does the nurse anticipate the health care provider will prescribe for a client who is beginning treatment for obsessive-compulsive disorder (OCD)?

Fluvoxamine

The nurse is caring for clients with obsessive-compulsive disorder (OCD). Which progressive and debilitating disorder is most commonly seen with a late onset?

Hoarding

A client performs ritualistic washing of the hands and dishes, along with rearranging the table before settling down to a meal. What intervention does the nurse implement to help this client complete this daily routine? Select all that apply.

Include the time taken for the ritual in the day's timetable. Come to an agreement with the client on a time to stop the ritual. Encourage a gradual decrease in the time allotted for the ritual.

A client with obsessive-compulsive disorder tells the nurse, "I never thought I'd be able to survive the feeling of leaving a room without going back through the door eight times, but I just did it with my therapist!" This client's treatment most likely included:

exposure and response prevention.

The partner of a client with obsessive-compulsive disorder (OCD) reports that the client regularly exhibits "strange behaviors." What does the nurse tell the partner about these behaviors? Select all that apply.

It is an attempt by the client to overcome anxiety. It is associated with an irrational persistent thought. The client will repeat the act several times during the day.

A client states that the client copes with anxiety by cleaning compulsively, which irritates the client's spouse. What does the nurse consider this?

Maladaptive, because it is an avoidance response

While planning care for a child who has excoriation disorder, what would a nurse anticipate as part of the care for this client?

Monitor for infection and healing processes. CBT and ACT are highly recommended. Lesions are in various stages of healing. Client may require the use of corticosteroids.

A client with obsessive-compulsive disorder (OCD) has been assessed by the primary care provider. What treatment is most likely?

Paroxetine

What relaxation technique does the nurse teach the client with obsessive-compulsive disorder (OCD)?

Practicing deep breathing

What kind of behavior does the nurse anticipate observing when treating a client obsessed with blasphemous thoughts?

Praying repeatedly.

The psychiatric mental health nurse has received a referral from a community health nurse regarding a client who appears to have hoarding disorder. When planning this client's care, the nurse should prioritize what consideration?

Promoting the client's safety in the home environment

The nurse observes a client with symptoms of onychophagia becoming anxious. The client stops the behavior and starts putting a puzzle together. Which action should the nurse take?

Provide genuine praise that the client used a coping strategy.

The nurse is assisting a client with behavior therapy for OCD. What nursing intervention may help enhance self-esteem?

Provide opportunities for the client to accomplish an activity.

A client diagnosed with obsessive-compulsive disorder (OCD) answers the nurse's assessment questions but adds a lot of irrelevant details in their answers. What is the most therapeutic approach by the nurse when client uses circumferential speech?

Remain patient and allow the client to express their thoughts.

A client admitted to the hospital with pancreatitis is found repeatedly washing their hands. Over the course of the day, the nurse notes that the client has rubbed the skin on their hands raw. Which action would the nurse implement first?

Sit with the client and explore their feelings regarding their hospitalization.

A client with obsessive-compulsive disorder (OCD) states making a concerted effort to reduce the frequency and duration of rituals. What intervention should the nurse include to assist in these efforts?

Teach the client nonpharmacologic relaxation techniques

A client with obsessive-compulsive disorder describes all doorknobs as being contaminated with a variety of viruses. The client cleans each knob three times with paper towels before use. Such behavior allows the client to do what?

Temporarily reduce anxiety

The nurse is educating the client's family about compulsive behavior. The nurse is correct when making which statement?

The behavior neutralizes anxiety caused by obsessive thoughts.

The nurse is caring for a client who appears distressed and is repeatedly tapping the doorway. The client tells the nurse "I can't leave, I keep losing count." Which consideration(s) are relevant to working with the client? Select all that apply.

The client may feel shame about their symptoms. It is important to validate the overwhelming feeling. Communicating a belief that the client can regain control can help.

During a follow-up visit, the nurse is assessing for signs of stabilization in a client undergoing behavior therapy for obsessive-compulsive disorder (OCD). What sign not seen previously in therapy does the nurse recognize as an indication of stabilization?

The client completes daily routine within a specified time.

When assessing the insight and self-concept of a client with obsessive-compulsive disorder (OCD), what does the nurse note?

The client has a fear of "going crazy."

A client reports to the nurse that compulsive buying is causing distress and financial problems. What assessment findings does the nurse relate to compulsive buying?

The client has a high comorbidity for depression.

The nurse is assessing a client who has been receiving treatment for obsessive-compulsive disorder (OCD). What finding helps the nurse to evaluate the effectiveness of the treatment?

The client is able effectively carry out functional and occupational tasks.

The nurse is assessing the physiological effects of severe obsessive-compulsive disorder (OCD) in a client. What does the nurse expect to find during assessment?

The client is unable to maintain adequate personal hygiene.

The nurse is caring for a client with obsessive-compulsive disorder (OCD). What does the nurse tell the client's family about the disorder?

The client may need to try different medications until a satisfactory response is obtained.

The nurse is assessing a client who habitually counts the number of objects in the client's surroundings. What finding does the nurse identify with obsessive-compulsive disorder (OCD)? Select all that apply.

The client repeatedly counts objects several times in a day. The client develops anxiety if the count ends with an odd number. The client avoids an interview in an office situated on the ninth floor. The client's mother rearranges objects around the house several times a day.

The psychiatric mental health nurse has taught some relaxation techniques to a client with obsessive-compulsive disorder (OCD). What outcome would most clearly suggest that this intervention has been successful?

The client reports increased quality and quantity of sleep

The nurse is caring for a client undergoing cognitive behavior therapy for obsessive-compulsive disorder. How does the cognitive model describe the client's thought process? Select all that apply.

The client wants to control own thoughts. The client has intolerance for uncertainty. The client overestimates the threats caused by the thoughts.

Which best describes the primary goal of treatment for obsessive-compulsive disorder?

The client will consistently use techniques to manage symptoms.

The nurse is providing care for a client who has obsessive-compulsive disorder (OCD). What aspect of this client's history was the most likely contributor to its etiology?

The client's mother had OCD

What does the nurse find on assessment of the thought processes of a client with obsessive-compulsive disorder (OCD)?

The obsessions become intense as the client tries to stop the behavior.

A nurse is providing a teaching seminar at the community center on emerging technologies for clients with obsessive-compulsive disorder (OCD). What should the nurse include in this presentation? Select all that apply.

Treatment can be tailored to the individual. Diagnostic procedures can be defined. Moment-to-moment condition monitoring for actional outcomes. Many new changes are available for assessment and management of OCD.

A client's older parent has been diagnosed with hoarding disorder. What does the nurse instruct the client about the parent's hoarding disorder?

Treatment may involve community agencies.

What kinds of thoughts does the nurse identify in a client with obsessive-compulsive disorder (OCD)? Select all that apply.

Unwanted Intrusive Impulsive

The nurse is teaching relaxation techniques to a client with obsessive-compulsive disorder (OCD). When does the nurse teach relaxation techniques to the client?

When the client is experiencing low anxiety levels.

The school nurse reviews their notes on students who have visited the clinic over the previous month. Which student would be considered more likely to develop an obsessive-compulsive disorder?

a 10-year-old client who becomes distraught if unable to complete tasks

A nurse is providing care to several clients with obsessive-compulsive disorder. Which client would the nurse identify as most likely to benefit from psychosurgery?

a client with severe obsessive compulsive disorder who has not responded to conservative treatment

Upon assessment, a client with a history of obsessive-compulsive disorder is terrified of losing control and has weight overvaluation. For what comorbidity should the nurse assess in the client?

eating disorder

The psychiatric mental health is reviewing the health record of a client who will soon be admitted. The client's health history includes a diagnosis of body dysmorphic disorder. The nurse should anticipate that this client:

is fixated on a specific physical flaw.

The nurse provides education regarding the introduction of virtual services provided by mental health care practitioners. Which expectation of virtual service does the nurse include in the teaching session? Select all that apply.

ncrypt client data in transit and in storage. Protect display screens from incidental viewing. Exchange protected health information (PHI) only when necessary. Ensure that audio transmissions are protected from eavesdropping. Negotiate HIPAA-compliant business associate agreement (BAA) with cloud hosts.

A nurse is caring for a client with obsessive-compulsive disorder who continually checks appliances to be sure the appliances are turned off. Which areas should the nurse address in the plan of care? Select all that apply.

relaxation techniques such as deep breathing cognitive restructuring for dysfunctional thoughts thought stopping when having obsessional thoughts

The nurse performs a screening for obsessive-compulsive disorder (OCD) with a client who displays symptoms of distress and a withdrawn affect. Which other screening is a priority to perform?

suicide risk assessment

The nurse is providing care for a client who has a compulsive hair-pulling disorder. Which disorder should the nurse document for this client?

trichotillomania