Ch. 15 PrepU questions, NUR444 PrepU Ch.15, Chapter 15: Obsessive-Compulsive and Related Disorders, NSG 211 - CH 15 OCD, Ch 15 Anxiety and Obsessive-Compulsive Related Disorders, Chapter 15: Obsessive-Compulsive and Related Disorders

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

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."

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

The nurse is assessing an older client with late onset of obsessive-compulsive disorder (OCD). What assessment does the nurse perform for this client? Select all that apply. Assess for degenerative disorders. Assess client for onychophagia. Check for a family history of OCD. Obtain history of recent infections. Assess for possible brain injury.

Assess for degenerative disorders. Obtain history of recent infections. Assess for possible brain injury. Explanation: Late onset of OCD may be triggered by an organic cause such degenerative disorders, infections, or brain injury. The nurse must alert the health care provider about the cause for the disorder. The nurse does not assess the client for onychophagia or nail biting. This disorder begins in childhood and subsides by age 18 for most clients. Clients with an early onset of OCD have a greater likelihood of family history of OCD. OCD other than hoarding rarely manifests after the age of 50.

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 performing a repetitive ritual. After the client has taken medication. When the client is experiencing low anxiety levels. Just before the client goes to bed.

Correct response: When the client is experiencing low anxiety levels. Explanation: The nurse teaches relaxation techniques when the client's anxiety level is low. This helps the client learn the technique more effectively and the client begins to use these techniques when anxiety increases. The nurse does not interrupt the client during a repetitive ritual because it agitates the client. The nurse does not teach relaxation techniques after the client has taken medication. The client has disturbed sleep so the nurse promotes a comfortable and quiet environment for the client.

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

Help the client find alternative methods to deal with anxiety. Explanation: The nurse teaches the client alternative methods such as deep breathing to deal with anxiety. The nurse provides opportunities to allow the client to perform tasks enjoyed by the client. Accomplishing these tasks in a set time enhances confidence and self-esteem. The client is encouraged to develop social skills by interacting with other staff members and clients. The client is given a room that is quiet and dimly lit room to promote sleep and rest.

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 Maladaptive, because it bothers the client's spouse Adaptive, because the client chooses to clean Adaptive, because the client's behavior isn't harming anyone

Maladaptive, because it is an avoidance response Explanation: Clients learn to reduce the anxiety they feel in either functional or dysfunctional ways. -Functional responses tend to be voluntary, conscious behaviors that address and acknowledge the stressful situation and help clients to find solutions. -Dysfunctional responses tend to be involuntary, inflexible, avoidance-type solutions that impair productivity. The nurse should not ask the client to give up coping mechanisms, even maladaptive ones, without offering other adaptive mechanisms. In other words, it is not appropriate to expect a client to just stop worrying, compulsively checking doors, or otherwise trying to cope with anxiety.

The nurse is caring for a client who has been admitted by the family to the health care facility. The client is unwilling to discuss obsessive-compulsive disorder (OCD) symptoms. Besides the standard therapy, what additional therapy does the nurse recommend for this client? Psychodynamic therapy Interpersonal therapy Online self-help therapy Follow-up therapy

Online self-help therapy Explanation: Online self-help therapy can be an effective add-on to standard therapy. This is especially beneficial for clients who are ashamed and stigmatized by their OCD symptoms and unwilling to discuss it with the nurse. Psychodynamic and interpersonal therapy are not typically recommended for treatment of OCD. If these treatments are used, it would be with the aim of treating other issues the client is experiencing comorbid to the OCD, not the OCD alone. The client who is unwilling to share fears and obsessions may not report for follow-up therapy.

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 Administer mood stabilizers as prescribed Teach the client how to complete the client's rituals in less time Educate the client about the negative effects of obsessions and compulsions

Teach the client nonpharmacologic relaxation techniques Explanation: Reducing the frequency of rituals for a person with OCD causes anxiety. Clients consequently benefit from learning techniques that can reduce their stress in a healthy way. Mood stabilizers are not typically used in the treatment of OCD, and nurses do not normally facilitate the performance of rituals. The client is likely aware of the negative consequences of obsessions and rituals, as evidenced by efforts to eliminate them.

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

The behavior neutralizes anxiety caused by obsessive thoughts. Explanation: The client attempts to suppress or ignore the intrusive thoughts by indulging in ritualistic behavior. This behavior neutralizes the anxiety caused by obsessive thoughts. However, the thoughts and behaviors are not realistically connected. The client becomes agitated and anxiety levels increase when prompted to stop by external stimuli. The client has normal intellectual functioning and is not on the verge of insanity.

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 client identifies stresses and anxieties. The client verbalizes conflicting thoughts and fears. The client recognizes and lists strengths and abilities.

The client completes daily routine within a specified time. Explanation: The client who has achieved stabilization following behavior therapy for OCD is able to complete the daily routine within a specified time. The other outcomes are expected in a client in the immediate phase of behavior therapy. In that phase, the client is able to identify stresses and anxieties, talk to the nurse about conflicting thoughts and fears and, with nursing staff help, recognize personal strengths and abilities.

When assessing the insight and self-concept of a client with obsessive-compulsive disorder (OCD), what does the nurse note? The client has the will power to stop intrusive thoughts. The client has a fear of "going crazy." The client is unable to make sound judgments. The client feels that the images and thoughts are real.

The client has a fear of "going crazy." Explanation: Clients with OCD express concern that they may be "going crazy." Feelings of powerlessness to control the obsessions or compulsions contribute to their low self-esteem. These clients also feel that they could control the thoughts and behaviors if they had stronger willpower. These clients are able to make sound judgments but are unable to act on them. Clients with OCD are aware that the intrusive images and thoughts are irrational, but they cannot control the overwhelming anxiety.

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 establishes adequate nutrition after 1 to 2 days. The client is able to sleep for at least 4 hours per night after 5 days. The client is able to identify the cause of anxiety after 1 week. The client is able to identify individual strengths and abilities after 2 weeks.

The client is able to sleep for at least 4 hours per night after 5 days. Explanation: The client responding effectively to treatment must be able to sleep for at least 4 hours per night. -Adequate nutrition must be established within 4 to 5 days. -The client is expected to identify the cause of stress and anxiety within 2 to 3 days. -Individual strengths and abilities must be identified and reviewed with staff within 3 to 4 days.

Which goal is appropriate for the client being treated for obsessive-compulsive disorder with response prevention therapy? The client will demonstrate an understanding of the benefits of deep breathing within 2 days. The client will experience notably less anxiety when engaged in delaying the ritual within 3 months. The client will implement relaxation techniques to help manage his or her anxiety within 2 days. The client will deliberately confront the trigger of his or her anxiety within 3 months.

The client will experience notably less anxiety when engaged in delaying the ritual within 3 months. Explanation: Response prevention focuses on delaying or avoiding performance of rituals. The client learns to tolerate the thoughts and the anxiety and to recognize that it will recede without the disastrous imagined consequences. Other techniques, such as deep breathing and relaxation, can also assist the person to tolerate and eventually manage the anxiety. Exposure involves assisting the client to deliberately confront the situations and stimuli that he or she usually avoids.

What intervention does the nurse implement to enable the client with repetitive behavior to complete daily activities? Tell the client to take as much time as needed to complete the task. Limit stimuli that activate repetitive behavior in the client. Verbally direct the client during the activity. Allow family to participate in the activity.

Verbally direct the client during the activity. Explanation: -The nurse talks and guides the client throughout the activity to prevent the client from being distracted by anxious thoughts. -Telling the client to take as much time as is needed to complete the task gives the client permission to engage in maladaptive rituals to neutralize anxiety rather than work at developing healthier coping through the use of exposure and response therapy. The client may not be able to estimate the amount of time a normal person would need to complete the given task. -The nurse does not try to limit stimuli that activate repetitive behavior. The client must learn to overcome these stresses during behavior therapy. -The family does not participate in the activity but the nurse teaches the family about the illness and methods of treatment.

2.Which of the following characteristics describe the obsessional thoughts experienced by clients with OCD? a.Intrusive b.Realistic c.Recurrent d.Uncontrollable e.Unwanted f.Voluntary

a.Intrusive c.Recurrent d.Uncontrollable e.Unwanted

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: agree on a consistent expectations for the client's behavior. establish meaningful consequences for the client in case of nonadherence. allow the client to lead the care conference and identify the desired outcomes. identify the precise etiology of the client's obsessive-compulsive disorder.

agree on a consistent expectations for the client's behavior. Explanation: The care team must be agreed on the expectations for the client in order to promote recovery. It is not possible to identify the precise etiology of a multifactorial disease like OCD. The client's preferences and goals are important, but it is unrealistic to expect the client to lead an interdisciplinary care conference. Adherence is promoted through positive reinforcement, not negative consequences.

Interventions for a client with OCD would include a.encouraging the client to verbalize feelings. b.helping the client avoid obsessive thinking. c.interrupting rituals with appropriate distractions. d.planning with the client to limit rituals. e.teaching relaxation exercises to the client. f.telling the client to tolerate any anxious feelings.

d.planning with the client to limit rituals. e.teaching relaxation exercises to the client. f.telling the client to tolerate any anxious feelings.

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. thought stopping. cue cards. progressive relaxation.

exposure and response prevention. Correct response: exposure and response prevention. Explanation: "Pushing through" a client's compulsion in order to face the resulting anxiety is characteristic of ERP. Thought stopping, cue cards and relaxation do not involve this direct form of confrontation with compulsions.

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 should be feeling better in a week once I am on the medication." "I will not feel sleepy as a side effect of the medication." "I should take the medication on an empty stomach. "I may have a risk of suicidal thoughts with the medication."

"I may have a risk of suicidal thoughts with the medication." Explanation: The client would have a risk of suicidal thoughts so needs to be aware so that these can be reported to the healthcare provider. The medication would take usually several weeks before the client notices therapeutic effects so should not expect to feel better in a week. The medication also has a side-effect of sedation so that the client should be careful with driving and operating heavy machinery. The medication is best taken with food, not on an empty stomach.

Which statement by the nurse providing care for a client diagnosed with obsessive-compulsive disorder (OCD), indicates a need for additional education regarding the client's ritualistic hand washing? "Let me help you find something less time consuming to do to manage your anxiety." "Let's talk about how this ritualistic behavior makes you feel." "I believe you when you say you just can't stop washing your hands." "Let's talk about how you plan to manage your anxiety in the years to come."

"Let me help you find something less time consuming to do to manage your anxiety." Explanation: People with OCD are usually aware that their ritualistic behavior appear senseless or even bizarre to others. Given that, family and friends may believe that the person "should just stop" the ritualistic behavior. "Just find something else to do" or other unsolicited advice only adds to the guilt and shame that people with OCD experience. It is important for the nurse (and other health professionals) to avoid taking that same point of view. Most times, people with OCD appear "perfectly normal" and therefore capable of controlling their own behavior. The nurse must remember that overwhelming fear and anxiety interfere with the person's ability to monitor or control their own actions. In addition, OCD is often chronic in nature, with symptoms that wax and wane over time. Just because the client has some success in managing thoughts and rituals doesn't mean they will never need professional help in the future.

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." "It sounds like you're trying to address a problem that in all likelihood doesn't exist." "What would you say to me if I had similar rituals with locking and unlocking doors?" "Is there a history of OCD or any other mental health disorders in your family?"

"The process you're describing sounds like it must require quite a bit of time and energy." Explanation: Saying, "The process you're describing sounds like it must require quite a bit of time and energy" encourages the client to elaborate on the effect that the client's rituals have on the client's life. Rapport is likely to be harmed if the nurse focuses on "a problem that doesn't exist." Focusing on the prevalence of mental health disorders is likely to inhibit communication at this fragile, early stage of the nurse-patient relationship. Turing the tables by asking, "What would you say to me if I had similar rituals with locking and unlocking doors?" is not a recognized therapeutic technique.

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.

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?"

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 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.

What intervention does the nurse perform to assist the client in decreasing the frequency of repetitive behaviors? Teach the client to practice conversation and attentive listening. Help the client identify supportive resources in the community. Assist the client to keep a record of when time is used in performing activities. Interrupt repeated behaviors to reduce the time used for activities.

Assist the client to keep a record of when time is used in performing activities. Explanation: The nurse should teach the client to keep a record of the frequency of and time used to perform activities. This helps the client to observe the decrease, an improvement in the condition. The client who avoids people and has limited social contact is taught conversation and attentive listening. The nurse helps the client who needs long-therapy to identify supportive resources in the community. The client is usually agitated when repeated behaviors are interrupted by others in an attempt to reduce the time taken for 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. Assists the client to interact with other clients. Tries various selective serotonin reuptake inhibitor (SSRI) medications to determine a right fit. Distracts the client during compulsive rituals.

Assists the client to confront situations. Explanation: During "exposure" phase of behavior therapy, the nurse assists the client to confront situations that the client normally tries to avoid. The nurse should assist clients with interacting with other clients to build self-confidence to prepare a good plan of care. These interventions, however, are not part of the exposure phase of behavior therapy. Trying SSRI medication is not a component of exposure therapy but can be used concomitantly with this type of treatment for OCD. The client must not be distracted during compulsive rituals as it agitates the client and increases anxiety.

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? Learn deep breathing exercises. Chronicle situations that trigger obsessions. Seek assistance of family to complete daily activities. Follow a written schedule with specified times for completion.

Chronicle situations that trigger obsessions. Explanation: Exposure and behavioral prevention therapy begins by having the client maintain a diary to note the situations that trigger obsessions, time spent performing the ritual behavior, and avoidance behaviors. Relaxation techniques to assist in managing anxiety can be performed regardless of participation in exposure and response prevention therapy. This is also true of following a written schedule with specified times for completion. The client must be able to complete daily activities without assistance in a scheduled time frame.

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

Correct response: "Do you get enjoyment out of all the clothes you buy?" Explanation: Oniomania, or compulsive buying, is an acquisition type of reward-seeking behavior. The pleasure is in acquiring the purchased object rather than any subsequent enjoyment of its use. Once acquired, the object may be infrequently or never used. The person demonstrating oniomaniac behaviors is not usually suicidal. Kleptomania is compulsive stealing while body identity integrity disorder (BIID) involves the removal or amputation of alienated body parts.

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

Correct response: "I check until my anxiety subsides." Explanation: The client engages in the ritualistic behavior of rechecking the lock when the anxiety becomes overwhelming. The client is unable to control the client's thoughts. This is a behavior distinctive of OCD. The client with OCD can make sound judgments and recognizes that obsessions are irrational. A person may recheck because the lock is not secure or just to make sure the door is locked. A person may simply double-check the lock. These people are not exhibiting irrational thought process and therefore do not have OCD.

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

Correct response: "It's important to know that the symptoms will intensify during periods of stress." Explanation: OCD is a chronic, progressive disease. Symptoms wax and wane over time, increasing during periods of stress. While the other statements are accurate, they do not provide the most general, encompassing information regarding the management of this chronic, progressive disorder.

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 A client who has a pattern of overeating and then inducing vomiting A client who is more than 150 pounds overweight but who believes the self to be healthy A client who is dangerously underweight but persists in weight-loss efforts

Correct response: A client who firmly believes that everyone who sees the client fixates on the size of the client's ears Explanation: BDD is characterized by a disproportionate focus on a minor physical characteristic. Clients with BDD do not necessarily binge and purge or engage in dangerous weight loss. Underestimation of obesity is not typical of BDD.

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. The client experiencing compulsions has insight into the disorder. An obsession responds well to psychiatric treatment. The client experiencing an obsession usually experiences delusions as well.

Correct response: A compulsion involves repeating a seemingly purposeful action. Explanation: An obsession is a persistent, painful, and intrusive thought, emotion, or urge that the client is unable to suppress or ignore, while a compulsion is the performance of a repetitious, seemingly purposeful act to prevent some future event or situation.

What intervention does the nurse perform to assist the client in decreasing the frequency of repetitive behaviors? Teach the client to practice conversation and attentive listening. Help the client identify supportive resources in the community. Assist the client to keep a record of when time is used in performing activities. Interrupt repeated behaviors to reduce the time used for activities.

Correct response: Assist the client to keep a record of when time is used in performing activities. Explanation: The nurse should teach the client to keep a record of the frequency of and time used to perform activities. This helps the client to observe the decrease, an improvement in the condition. The client who avoids people and has limited social contact is taught conversation and attentive listening. The nurse helps the client who needs long-therapy to identify supportive resources in the community. The client is usually agitated when repeated behaviors are interrupted by others in an attempt to reduce the time taken for 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. Assists the client to interact with other clients. Tries various selective serotonin reuptake inhibitor (SSRI) medications to determine a right fit. Distracts the client during compulsive rituals.

Correct response: Assists the client to confront situations. Explanation: During "exposure" phase of behavior therapy, the nurse assists the client to confront situations that the client normally tries to avoid. The nurse should assist clients with interacting with other clients to build self-confidence to prepare a good plan of care. These interventions, however, are not part of the exposure phase of behavior therapy. Trying SSRI medication is not a component of exposure therapy but can be used concomitantly with this type of treatment for OCD. The client must not be distracted during compulsive rituals as it agitates the client and increases anxiety.

The nurse is caring for a client with obsessive-compulsive disorder (OCD). What are the expected outcomes for the client who has been stabilized by medication and behavior therapy? Continue follow-up therapy as needed. Verbalize knowledge of illness and treatment plan. List strengths and abilities to the nursing staff. Identify stresses and anxieties.

Correct response: Continue follow-up therapy as needed. Explanation: Clients with OCD who have been stabilized by medication and behavior therapy may experience long-term difficulties in dealing with obsessive thoughts. These clients are encouraged to continue follow-up therapy. The expected outcome for clients in the stabilization phase of therapy is verbalizing knowledge of illness and treatment plan. In the immediate phase of therapy, clients should be able to list and review strengths and abilities with the nursing staff. These clients should also be able identify stresses and anxieties to enable the nurse to develop a plan of care.

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

Correct response: Early onset may indicate family history of OCD. Explanation: Early onset of OCD indicates the likelihood of a family history of OCD. OCD starts in childhood especially in males. In females the onset is in the 20s. OCD is diagnosed only when the client's compulsive behavior interferes with the client's personal, social, and occupational function.

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

Correct response: Encourage the client to participate in follow-up therapy. Explanation: Clients with OCD experience long-term difficulties in dealing with obsessive thoughts. The nurse helps the client identify supportive resources in the community. Medications are just as important as mastering behavior therapy. The client must not stop medications without consulting the health care provider. The nurse asks the client to practice relaxation techniques when the client's anxiety level is low and apply them when anxiety levels increase. The client must learn to tolerate obsessive thoughts and complete daily activities without help from others.

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? Body dysmorphic disorder Disrupted family dynamics Excoriation disorder Control dysfunction

Correct response: Excoriation disorder Explanation: Excoriation disorder (skin picking) is the inability to stop recurrent picking at skin for emotional release or anxiety release. Body dysmorphic disorder is a preoccupation with slight or imagined physical defects that are not apparent to others. There is not enough information to diagnose disrupted family dynamics or control issues within the family unit.

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 Loss of hair in patches Very short nails Dry, cracked hands

Correct response: Excoriation of the skin Explanation: The client with dermatillomania attempts to reduce anxiety by picking on the skin. This client has excoriated skin. Trichotillomania is a disorder which causes the client to repeatedly pull the hair to reduce anxiety. The client with onychophagia is likely to have very short nails due to frequent nail biting. Frequent and ritualistic hand washing is an obsessive compulsive disorder leading to dry, cracked hands.

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

Correct response: Fluvoxamine Explanation: The client who is beginning treatment for OCD is prescribed the selective serotonin reuptake inhibitor depressant fluvoxamine as a first-line choice. Clients with treatment-resistant OCD may respond to second-generation antipsychotics such as risperidone, quetiapine, and olanzapine.

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

Correct response: Help the client find alternative methods to deal with anxiety. Explanation: The nurse teaches the client alternative methods such as deep breathing to deal with anxiety. The nurse provides opportunities to allow the client to perform tasks enjoyed by the client. Accomplishing these tasks in a set time enhances confidence and self-esteem. The client is encouraged to develop social skills by interacting with other staff members and clients. The client is given a room that is quiet and dimly lit room to promote sleep and rest.

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 Maladaptive, because it bothers the client's spouse Adaptive, because the client chooses to clean Adaptive, because the client's behavior isn't harming anyone

Correct response: Maladaptive, because it is an avoidance response Explanation: Clients learn to reduce the anxiety they feel in either functional or dysfunctional ways. Functional responses tend to be voluntary, conscious behaviors that address and acknowledge the stressful situation and help clients to find solutions. Dysfunctional responses tend to be involuntary, inflexible, avoidance-type solutions that impair productivity. The nurse should not ask the client to give up coping mechanisms, even maladaptive ones, without offering other adaptive mechanisms. In other words, it is not appropriate to expect a client to just stop worrying, compulsively checking doors, or otherwise trying to cope with anxiety.

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

Correct response: Paroxetine Explanation: Paroxetine is a sustained serotonin reuptake inhibitor (SSRI). SSRIs are a first line treatment for OCD. Phenelzine is a monoamine oxidase inhibitor and olanzapine is an antipsychotic; neither are commonly used to treat OCD. Benzodiazepines such as lorazepam are not normally used.

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

Correct response: Practicing deep breathing Explanation: The nurse teaches the client deep breathing for relaxation. The nurse encourages the client to practice deep breathing when anxiety increases. The client is taught to maintain a diary to note down situations that trigger obsessions. The nurse sets a timetable for the client's daily routine. This helps to ensure that the client completes tasks within a scheduled time. The effect of music on clients with OCD is not known.

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

Correct response: Praying repeatedly. Explanation: The client obsessed with blasphemous thoughts is compelled to pray or chant. The client obsessed with order vacuums the rug in a particular direction. The client worried about infection or cleanliness washes and scrubs until the skin is raw. Some clients have an obsession for counting; they count each step taken, tiles, and other objects in the surroundings.

A nurse is assessing a client and suspects obsessive-compulsive disorder .The nurse understands that to rule a behavior as obsessive-compulsive disorder (OCD), the obsession or compulsion must meet which criteria? B e the client's primary thought process throughout the entire day. Cause considerable anguish if not performed first thing in the morning. Take up more than 1 hour/day and cause stress to the client. Convince the client that the obsessive thoughts are true.

Correct response: Take up more than 1 hour/day and cause stress to the client. Explanation: OCD is diagnosed when recurrent obsessions or compulsions (or both) take up more than 1 hour a day or cause considerable stress to the individual. These obsessions or compulsions are not caused by substance or medication use or other disorders. Some individuals recognize that these obsessions or compulsions are excessive and unrealistic; others have limited insight and are unsure whether the obsessive thoughts are true but continue to have the thoughts and feel compelled to perform the actions. Another group of individuals are convinced that their obsessive thoughts are true. These thoughts and compulsive behaviors are stressful and interfere with normal daily routines.

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 Administer mood stabilizers as prescribed Teach the client how to complete the client's rituals in less time Educate the client about the negative effects of obsessions and compulsions

Correct response: Teach the client nonpharmacologic relaxation techniques Explanation: Reducing the frequency of rituals for a person with OCD causes anxiety. Clients consequently benefit from learning techniques that can reduce their stress in a healthy way. Mood stabilizers are not typically used in the treatment of OCD, and nurses do not normally facilitate the performance of rituals. The client is likely aware of the negative consequences of obsessions and rituals, as evidence by efforts to eliminate them.

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

Correct response: The behavior neutralizes anxiety caused by obsessive thoughts. Explanation: The client attempts to suppress or ignore the intrusive thoughts by indulging in ritualistic behavior. This behavior neutralizes the anxiety caused by obsessive thoughts. However, the thoughts and behaviors are not realistically connected. The client becomes agitated and anxiety levels increase when prompted to stop by external stimuli. The client has normal intellectual functioning and is not on the verge of insanity.

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 client identifies stresses and anxieties. The client verbalizes conflicting thoughts and fears. The client recognizes and lists strengths and abilities.

Correct response: The client completes daily routine within a specified time. Explanation: The client who has achieved stabilization following behavior therapy for OCD is able to complete the daily routine within a specified time. The other outcomes are expected in a client in the immediate phase of behavior therapy. In that phase, the client is able to identify stresses and anxieties, talk to the nurse about conflicting thoughts and fears and, with nursing staff help, recognize personal strengths and abilities.

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 has a fear of contamination. The client is obsessed with cleanliness. The client is preoccupied with perfection. The client is obsessed with blasphemous thoughts.

Correct response: The client is preoccupied with perfection. Explanation: The client who is obsessed with perfection performs compulsive rituals such as arranging and rearranging items around the house. The client who has a fear of contamination is obsessed with cleanliness. This client repeatedly washes hands and cleans and scrubs the surroundings. The client who is obsessed with blasphemous thoughts engages in repeated prayers or confession.

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

Correct response: The client performs the ritual to relieve anxiety temporarily. Explanation: The nurse needs to explain to the spouse that the client's compulsion is done to relieve anxiety temporarily. The compulsion is necessary, not pleasurable, and if not performed, increased anxiety and distress occur. The compulsion is an anxiety response, not a means to control the situation or promote safety. Thought stopping is a mechanism used to control obsessions.

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

Correct response: The client reports increased quality and quantity of sleep Explanation: Relaxation techniques can reduce anxiety and improve sleep. They are less likely to enhance insight. Thought blocking focuses on stopping 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? The client's mother had OCD The client was neglected as a child The client abused alcohol heavily as a teenager The client has a type D personality

Correct response: The client's mother had OCD Explanation: OCD has a genetic component. Psychosocial factors such as child neglect, substance abuse, and personality type are thought to be less significant than neurobiologic factors.

What does the nurse find on assessment of the thought processes of a client with obsessive-compulsive disorder (OCD)? The client has gradual memory loss. The client's intellectual functioning is deteriorating. Obsessions occur when the client is not engaged in an activity. The obsessions become intense as the client tries to stop the behavior.

Correct response: The obsessions become intense as the client tries to stop the behavior. Explanation: Clients with OCD do not willingly have obsessions or images, and their obsessions become more intense when they try to prevent them. Clients with OCD do not experience effects in memory or intellectual functioning. However, they have difficulty concentrating when the obsessions are strong. For most, the obsessions arise out of nowhere, during other activities.

A client is diagnosed with trichotillomania. What would the nurse expect to observe with the client? report by the client about having large ears skin redness and irritation over bilateral arms hair loss on the scalp, eyebrows and/or eyelashes reddened hands from continuous hand-washing

Correct response: hair loss on the scalp, eyebrows and/or eyelashes Explanation: A client with trichotillomania would have a loss of hair from hair-pulling including the scalp, eyebrows and eyelashes. Reddened hands from handwashing would be associated with obsessive-compulsive disorder. Skin redness and potential skin breakdown would be associated with excoriation (skin-picking) disorder. A report by the client about having large ears would be associated with body-dysmorphic disorder.

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

Early onset may indicate family history of OCD. Explanation: Early onset of OCD indicates the likelihood of a family history of OCD. OCD starts in childhood especially in males. In females the onset is in the 20s. OCD is diagnosed only when the client's compulsive behavior interferes with the client's personal, social, and occupational function.

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

Encourage the client to participate in follow-up therapy. Explanation: Clients with OCD experience long-term difficulties in dealing with obsessive thoughts. The nurse helps the client identify supportive resources in the community. Medications are just as important as mastering behavior therapy. The client must not stop medications without consulting the health care provider. The nurse asks the client to practice relaxation techniques when the client's anxiety level is low and apply them when anxiety levels increase. The client must learn to tolerate obsessive thoughts and complete daily activities without help from others.

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. Reward the client for every activity that is performed. Teach the client to avoid trigger situations. Talk to the client in a calm, reassuring voice.

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. Explanation: Nursing interventions for OCD include encouraging the client to perform activities of daily living within a fixed time, teaching the client social skills such as appropriate conversation topics, and teaching the client to avoid trigger situations. The nurse should not provide undue praise, such as rewarding the client for every activity. Clients with OCD benefit from genuine praise that is earned. The nurse should convey interest when speaking to the client; however, a calm, reassuring voice is not necessary. This tone is used with clients experiencing a panic attack.

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? Failing classes due to a lack of concentration. Spending excessive amount of times in the child's room. Frequently "staring off into space." Appearing jittery and nervous all the time.

Failing classes due to a lack of concentration. Explanation: Assessment reveals intact intellectual functioning. The client may describe difficulty concentrating or paying attention when obsessions are strong. Because children subscribe to myths, superstition, and magical thinking, obsessive and ritualistic behaviors may go unnoticed. Behaviors such as touching every third tree, avoiding cracks in the sidewalk, or consistently verbalizing fears of losing a parent in an accident may have some underlying pathology but are common behaviors in childhood. Typically, parents notice that a child's grades begin to fall as a result of decreased concentration and great amounts of time spent performing rituals. Isolating themselves, staring off into space, and being nervous could be considered normal behavior at certain developmental ages.

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

Fluvoxamine Explanation: The client who is beginning treatment for OCD is prescribed the selective serotonin reuptake inhibitor depressant fluvoxamine as a first-line choice. Clients with treatment-resistant OCD may respond to second-generation antipsychotics such as risperidone, quetiapine, and olanzapine.

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

Paroxetine Explanation: Paroxetine is a sustained serotonin reuptake inhibitor (SSRI). SSRIs are a first line treatment for OCD. Phenelzine is a monoamine oxidase inhibitor and olanzapine is an antipsychotic; neither are commonly used to treat OCD. Benzodiazepines such as lorazepam are not normally used.

What does the nurse teach the client with obsessive-compulsive disorder about reducing anxiety? Select all that apply. Practice guided imagery. Perform progressive muscle relaxation. Reduce time spent on rituals. Breathe deeply when anxiety increases. Refrain from discussing the obsessions.

Practice guided imagery. Perform progressive muscle relaxation. Reduce time spent on rituals. Breathe deeply when anxiety increases. Explanation: The nurse teaches the client to practice relaxation techniques such as guided imagery, progressive muscle relaxation, and deep breathing. The client should apply these techniques when anxiety levels increase. The client should gradually reduce time spent on rituals. The client openly discusses obsessions with the nurse and family to relieve anxiety caused by the "burden" of keeping a secret.

The nurse is interviewing a client who is being treated for obsessive-compulsive disorder (OCD). The client's compulsions involve cleanliness rituals, which the client justifies by describing potential contaminants in great detail. The nurse interprets the client's statement as implying that: the client may lack insight into the diagnosis. the client's fears can likely be alleviated by presenting evidence about the safety of water. the client may develop more serious obsessions and compulsions over time. the client would likely benefit from inpatient treatment.

the client may lack insight into the diagnosis. Explanation: The client's attempt to justify the client's obsessions and compulsions suggests a lack of insight. This does not mean, however, that the client's disease will worsen over time or that inpatient treatment is needed. Objective evidence does not dissuade clients from their obsessions or rituals.