Chapter 15 PrepU NRS330

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

Which client is most likely to benefit from the administration of selective serotonin reuptake inhibitors (SSRIs)?

A client whose obsessive-compulsive disorder (OCD) has not responded to cognitive- behavioral therapy

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.

What interventions does the nurse perform when caring for a client with obsessive-compulsive disorder (OCD)? Select all that apply.

Encourage the client to perform activities of daily living within a fixed time. Teach the client social skills such as appropriate conversation topics. Teach the client to avoid trigger situations.

A teenager and the teenager's parents visit the clinic to discuss the teen's skin picking. There are many bleeding wounds and various stages of scabs located up and down both arms. The parents are very upset about this behavior and want it to stop. Which would the health care provider document?

Excoriation disorder

The nurse is caring for a client with dermatillomania. What symptoms of this disorder does the nurse recognize in this client?

Excoriation of the skin

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

A client brought to the outpatient department by a family member is diagnosed with obsessive-compulsive disorder (OCD). What characteristic of OCD does the nurse expect to find during the assessment of the client?

Rituals that interfere with occupational function.

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 an adolescent with dermatillomania. What does the nurse tell the client's parent about this disorder? Select all that apply.

The client finds comfort in skin picking. It can lead to loss of occupational functioning. It can lead to medical complications.

The nurse is assessing a client who spends several hours arranging and rearranging items around the house. What does the nurse anticipate is the cause of this compulsive behavior?

The client is preoccupied with perfection.

The nurse is assessing a client with a strong urge to arrange and rearrange the items on the table several times a day. What other finding does the nurse associate with obsessive-compulsive disorder (OCD)?

The client is unable to tolerate deviations from routine.

A client with obsessive-compulsive disorder (OCD) spends several hours each day cleansing the home and washing the hands. The client tells the nurse, "I don't think you quite realize how many bacteria, viruses, and fungi live around us." What is the nurse's most accurate interpretation of this client's statement?

The client may lack insight into the OCD

A client diagnosed with obsessive-compulsive disorder comes to the clinic with the client's spouse. During the visit, the spouse states, "The client is always checking and rechecking to make sure that all of the appliances are turned off before we go out. It's nerve-wracking. We can never get out of the house on time. Isn't checking once enough?" An understanding of what would the nurse need to incorporate into the response?

The client performs the ritual to relieve anxiety temporarily.

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

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.

The nurse is assessing a teenage client with onychophagia. What does the nurse teach the parent about the disorder?

Treatment with selective serotonin reuptake inhibitor (SSRI) antidepressants is effective.

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

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

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

Praying repeatedly.

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.

The nurse is admitting a client with obsessive-compulsive disorder whose compulsion is washing hands. What should the nurse explain to the client?

"Applying lotion will help keep your skin from breaking down."

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

Unwanted Intrusive Impulsive

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 is teaching a client with obsessive-compulsive disorder about cognitive restructuring. Which client statement best demonstrates effectiveness of teaching?

"I may not always have harmful germs on my hands."

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 new client with a long-standing history of obsessive-compulsive disorder (OCD) is describing to the nurse the complex ritual of locking and unlocking a door after entering a room alone. What is the nurse's most therapeutic response?

"The process you're describing sounds like it must require quite a bit of time and energy."

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.

A nurse is planning care for a client who has been diagnosed with trichotillomania. Which outcome should the nurse include in the client's plan of care?

Client will demonstrate healthy coping strategies for dealing with stressors

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

Compulsion involves repeating a purposeful action

A client diagnosed with body dysmorphic disorder (BDD) will primarily focus on what?

Discussing real or imagined defects in appearance, such as having a "long" nose

What interventions does the nurse use to promote therapeutic communication with the client diagnosed with obsessive-compulsive disorder (OCD)?

Explore the thoughts and feelings that trouble the client.

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 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

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

Practicing deep breathing

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

What does the nurse teach the client with obsessive-compulsive disorder about relaxation techniques?

Relaxation techniques should be practiced whenever possible.

The nurse is assessing a client who performs ritualistic counting of objects in the client's surroundings. What does the nurse tell the client about obsessive-compulsive disorder and its treatment? Select all that apply.

Talk openly with the nurse about obsessions, compulsions, and anxiety. Do not skip medication; it is an important part of the treatment. Learn and practice deep breathing and guided imagery.

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

What signs of stabilization does the nurse recognize during the follow-up visit of a client undergoing behavior therapy for obsessive-compulsive disorder (OCD)?

The client completes daily routine within a specified time.

The nurse is caring for a client receiving fluvoxamine and behavior therapy for obsessive compulsive disorder. What outcome does the nurse expect of this client?

The client is able to sleep for at least 4 hours per night after 5 days.

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 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.

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

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.

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.

During an interview, a client diagnosed with obsessive-compulsive disorder tells the nurse, "I'm constantly worrying that something bad will happen to my mother and that she will die. So, I'm always praying so that this won't happen." The nurse interprets this as which obsessive-compulsive symptom dimension?

aggressive/sexual/religious/checking

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.

A client explains to the client's health care provider that the client has a cleaning ritual that the client goes through every day. If something disrupts this cleaning schedule, the client becomes:

extremely anxious.

A client is diagnosed with trichotillomania. What would the nurse expect to observe with the client?

hair loss on the scalp, eyebrows and/or eyelashes

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.