Ch. 15 PrepU questions

Which client is most likely to be diagnosed with body dysmorphic disorder (BDD)? 1.A client who firmly believes that everyone who sees the client fixates on the size of the client's ears 2.A client who is more than 150 pounds overweight but who believes the self to be healthy 3.A client who is dangerously underweight but persists in weight-loss efforts 4.A client who has a pattern of overeating and then inducing vomiting

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

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? 1.Encourage the client to participate in follow-up therapy. 2.Encourage the family to assist the client in completing daily activities. 3.Apply relaxation techniques when anxiety level is low. 4.Discontinue medications after mastering behavior therapy.

1.Encourage the client to participate in follow-up therapy.

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? 1.Excoriation disorder 2.Disrupted family dynamics 3.Control dysfunction 4.Body dysmorphic disorder

1.Excoriation disorder

The nurse is interviewing the parents of a child who is exhibiting obsessive-compulsive disorder (OCD). The nurse would anticipate that the parents would report the occurrence of which situation with the child? 1.Failing classes due to a lack of concentration. 2.Spending excessive amount of times in the child's room. 3.Frequently "staring off into space." 4.Appearing jittery and nervous all the time.

1.Failing classes due to a lack of concentration.

How does the nurse help to decrease anxiety and build confidence in a client with obsessive-compulsive disorder? 1.Help the client find alternative methods to deal with anxiety. 2.Provide opportunities to perform tasks usually avoided by the client. 3.Provide the client with a quiet and dimly lit room. 4.Permit minimal interactions with other clients during the therapy.

1.Help the client find alternative methods to deal with anxiety.

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? 1.The client is preoccupied with perfection. 2.The client is obsessed with blasphemous thoughts. 3.The client has a fear of contamination. 4.The client is obsessed with cleanliness.

1.The client is preoccupied with perfection.

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? 1.The client is unable to maintain adequate personal hygiene. 2.The client is energetic and completes activities quickly. 3.The client reports unwanted weight gain. 4.The client sleeps for 8 to 10 hours a day.

1.The client is unable to maintain adequate personal hygiene.

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? 1.The client performs the ritual to relieve anxiety temporarily. 2.The client's behavior reflects a need for safety. 3.The client is attempting to use thought stopping to decrease the behavior. 4.The client is attempting to exert control over the situation.

1.The client performs the ritual to relieve anxiety temporarily.

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. 1.The client wants to control own thoughts. 2.The client believes the client has no personal responsibilities. 3.The client lacks religious sentiments. 4.The client overestimates the threats caused by the thoughts. 5.The client has intolerance for uncertainty.

1.The client wants to control own thoughts. 4.The client overestimates the threats caused by the thoughts. 5.The client has intolerance for uncertainty.

A client's older parent has been diagnosed with hoarding disorder. What does the nurse instruct the client about the parent's hoarding disorder? 1.Treatment may involve community agencies. 2.Short-term treatment can provide a successful outcome. 3.It is a degenerative disorder. 4.It is caused by an injury to the basal ganglia.

1.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. 1.Unwanted 2.Intrusive 3.Impulsive 4.Interesting 5.Intelligent

1.Unwanted 2.Intrusive 3.Impulsive

The nurse is participating in an interdisciplinary care conference for a client who has obsessive-compulsive disorder (OCD). In order to best promote the client's recovery, the care team must: 1.agree on a consistent expectations for the client's behavior. 2.establish meaningful consequences for the client in case of nonadherence. 3.allow the client to lead the care conference and identify the desired outcomes. 4.identify the precise etiology of the client's obsessive-compulsive disorder.

1.agree on a consistent expectations for the client's behavior.

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: 1.exposure and response prevention. 2.progressive relaxation. 3.cue cards. 4.thought stopping.

1.exposure and response prevention.

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: 1.is fixated on a specific physical flaw. 2.likely exercises compulsively. 3.may engage in binging and purging. 4.has a powerful drive for thinness.

1.is fixated on a specific physical flaw.

What question by the nurse is focused on identifying oniomaniac tendencies in a client diagnosed with depression? 1."Do you ever feel like hurting yourself?" 2."Do you get enjoyment out of all the clothes you buy?" 3."Can you explain to me why you want to have your leg amputated?" 4."Have you ever been arrested for stealing?"

2."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)? 1."I don't think the lock is secured." 2."I check until my anxiety subsides." 3."There is nothing wrong in rechecking." 4."This part of the city is unsafe."

2."I check until my anxiety subsides."

Which medication does the nurse anticipate the health care provider will prescribe for a client who is beginning treatment for obsessive-compulsive disorder (OCD)? 1.Quetiapine 2.Fluvoxamine 3.Risperidone 4.Olanzapine

2.Fluvoxamine

A client states that the client copes with anxiety by cleaning compulsively, which irritates the client's spouse. What does the nurse consider this? 1.Maladaptive, because it bothers the client's spouse 2.Maladaptive, because it is an avoidance response 3.Adaptive, because the client's behavior isn't harming anyone 4.Adaptive, because the client chooses to clean

2.Maladaptive, because it is an avoidance response

The nurse is educating the client's family about compulsive behavior. The nurse is correct when making which statement? 1.The behavior eventually leads to insanity. 2.The behavior neutralizes anxiety caused by obsessive thoughts. 3.The client's thoughts and behaviors are realistically connected. 4.The client stops the ritual only when prompted by external stimuli.

2.The behavior neutralizes anxiety caused by obsessive thoughts.

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. 1.The client has a passion for numbers since childhood. 2.The client develops anxiety if the count ends with an odd number. 3.The client's mother rearranges objects around the house several times a day. 4.The client repeatedly counts objects several times in a day. 5.The client avoids an interview in an office situated on the ninth floor.

2.The client develops anxiety if the count ends with an odd number. 3.The client's mother rearranges objects around the house several times a day. 4.The client repeatedly counts objects several times in a day. 5.The client avoids an interview in an office situated on the ninth floor.

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? 1.The client may have contacted a severe infection or contamination earlier in life 2.The client may lack insight into the OCD 3.The client is unlikely to respond to conventional treatment for OCD 4.The client's OCD is the result of physiologic factors

2.The client may lack insight into the OCD

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. 1.The client is unaware of the act. 2.The client will repeat the act several times during the day. 3.It is an attempt by the client to overcome anxiety. It is indicative of a degenerative disorder. 4.It is associated with an irrational persistent thought.

2.The client will repeat the act several times during the day. 3.It is an attempt by the client to overcome anxiety. It is indicative of a degenerative disorder. 4.It is associated with an irrational persistent thought.

The nurse is caring for clients with obsessive-compulsive disorder (OCD). Which progressive and debilitating disorder is most commonly seen with a late onset? 1.Oniomania 2.Ordering 3.Hoarding 4.Onychophagia

3.Hoarding

The nurse is assisting a client with behavior therapy for OCD. What nursing intervention may help enhance self-esteem? 1.Reduce instances of stimuli that activate compulsive behavior. 2.Interrupt the client when performing a ritualistic behavior. 3.Provide opportunities for the client to accomplish an activity. 4.Ask client to perform deep breathing exercises instead of ritual behaviors.

3.Provide opportunities for the client to accomplish an activity.

The nurse is educating the client's family about compulsive behavior. The nurse is correct when making which statement? 1.The client stops the ritual only when prompted by external stimuli. 2.The client's thoughts and behaviors are realistically connected. 3.The behavior neutralizes anxiety caused by obsessive thoughts. 4.The behavior eventually leads to insanity.

3.The behavior neutralizes anxiety caused by obsessive thoughts.

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? 1.The client abused alcohol heavily as a teenager 2.The client was neglected as a child 3.The client's mother had OCD 4.The client has a type D personality

3.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)? 1.The client has gradual memory loss. 2.Obsessions occur when the client is not engaged in an activity. 3.The obsessions become intense as the client tries to stop the behavior. 4.The client's intellectual functioning is deteriorating.

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

What kind of behavior does the nurse anticipate observing when treating a client obsessed with blasphemous thoughts? 1.Counting each step taken. 2.Continually washing and scrubbing. 3.Vacuuming in a particular direction. 4.Praying repeatedly.

4. praying repeatedly

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? 1."The symptoms will require lifelong medication therapy." 2."OCD often lasts well into adulthood." 3."There are several comorbid conditions that can develop from the anxiety." 4."It's important to know that the symptoms will intensify during periods of stress."

4."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? 1."What would you say to me if I had similar rituals with locking and unlocking doors?" 2."Is there a history of OCD or any other mental health disorders in your family?" 3."It sounds like you're trying to address a problem that in all likelihood doesn't exist." 4."The process you're describing sounds like it must require quite a bit of time and energy."

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

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? 1.A panic attack 2.Acute stress disorder 3.An obsession 4.A compulsion

4.A compulsion

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? 1.Client will reestablish mutually supportive relationships with family members 2.Client will accurately describe the etiology and clinical course of trichotillomania 3.Client will consistently refrain from skin picking 4.Client will demonstrate healthy coping strategies for dealing with stressors

4.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? 1.Client experiencing compulsions has insight into the disorder 2.Obsession responds well to psychiatric treatment 3.Client experiencing an obsession usually experiences delusions as well 4.Compulsion involves repeating a purposeful action

4.Compulsion involves repeating a purposeful action

A client diagnosed with body dysmorphic disorder (BDD) will primarily focus on what? 1.Researching the client's family tree to pinpoint when the client's body part became defective 2.Analyzing why others think the client looks fine and that the client should just get on with life 3.Raising money to surgically repair a body part so that everything will return to "normal" 4.Discussing real or imagined defects in appearance, such as having a "long" nose

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

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? 1.It is diagnosed very early in most clients. 2.It starts in the 20s in male clients. 3.It starts in childhood in female clients. 4.Early onset may indicate family history of OCD.

4.Early onset may indicate family history of OCD.

A client with obsessive-compulsive disorder (OCD) has been assessed by the primary care provider. What treatment is most likely? 1.Phenelzine 2.Olanzapine 3.Lorazepam 4.Paroxetine

4.Paroxetine

What relaxation technique does the nurse teach the client with obsessive-compulsive disorder (OCD)? 1.Scheduling a timetable 2.Listening to music 3.Writing a diary 4.Practicing deep breathing

4.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? 1.Collaborating with law enforcement while maintaining the client's autonomy 2.Educating the client about the use of relaxation techniques 3.Teaching the client to differentiate between necessary and unnecessary items 4.Promoting the client's safety in the home environment

4.Promoting the client's safety in the home environment

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? 1.The client accurately describes the harmful effects of compulsions 2.The client demonstrates the ability to block negative thoughts 3.The client accurately describes the effects of obsessions on quality of life 4.The client reports increased quality and quantity of sleep

4.The client reports increased quality and quantity of sleep

The nurse is teaching relaxation techniques to a client with obsessive-compulsive disorder (OCD). When does the nurse teach relaxation techniques to the client? 1.Just before the client goes to bed. 2.When the client is performing a repetitive ritual. 3.After the client has taken medication. 4.When the client is experiencing low anxiety levels.

4.When the client is experiencing low anxiety levels.