Psych Nursing OCD PrepU
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."
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
A client who firmly believes that everyone who sees the client fixates on the size of the client's ears
The client has begun to wash the hands every hour due to the fear of germs becoming embedded in the client's skin leading the client to develop cancer. The nurse interprets this behavior as indicating which condition? An obsession A panic attack A compulsion Acute stress disorder
A compulsion
A patient's mental health disorder is characterized by the patient's excessive cleaning of her surroundings. How can the nurse best address the biochemical aspects of the patient's disorder? Administer sustained serotonin reuptake inhibitors (SSRIs) as prescribed Dialogue with the patient about isolation, undoing, and reaction forming Educate the patient about the relationship between cerebral glucose metabolism and mental health Administer anticonvulsants as prescribed
Administer sustained serotonin reuptake inhibitors (SSRIs) as prescribed
A client with a history of trichotillomania has experienced an exacerbation of the disorder that has resulted in the loss of most of the client's hair. The nurse should anticipate which intervention? Administration of an antipsychotic or antidepressant as prescribed Electroconvulsive therapy (ECT), unless contraindicated Administration of long-acting methylphenidate as prescribed Teaching the client to perform relaxation exercises
Administration of an antipsychotic or antidepressant as prescribed
The nurse is interviewing a client who has a history of obsessive-compulsive disorder involving fears of contamination. The client is delivering a long and detailed monologue about the topics of emerging viruses and antibiotic resistance. What is the nurse's best action? Allow the client to express her thoughts without interrupting Gently redirect the client toward the topic of her compulsions Ask the client about what she believes to be a reasonable response to these threats Acknowledge that the client's statements are accurate and then ask another interview question
Allow the client to express her thoughts without interrupting
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 Client will consistently refrain from skin picking Client will reestablish mutually supportive relationships with family members Client will accurately describe the etiology and clinical course of trichotillomania
Client will demonstrate healthy coping strategies for dealing with stressors
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 Phobia Obsession Derealization
Compulsion
The nurse correctly identifies that which of a client with OCD's self-soothing behaviors may involve self-destruction of the body? Select all that apply. Dermatillomania Trichotillomania Onychophagia Kleptomania Oniomania
Dermatillomania Trichotillomania Onychophagia
A child is suspected of having obsessive-compulsive disorder. Which of the following would be the first step in assessing the child? Distinguishing between normal childhood rituals and worries and those that are pathologic The frequency of which the child engages in the compulsions The amount of interference the rituals have on the child's functioning The severity of the family's response to the child's behavior
Distinguishing between normal childhood rituals and worries and those that are pathologic
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
Excoriation disorder
The psychiatric mental health nurse is planning the care of a client whose elaborate room entry and exit rituals have led to a diagnosis of obsessive-compulsive disorder (OCD). What action by the nurse best addresses possible psychodynamic aspects of the etiology? Exploring the characteristics of the client's defense mechanisms Monitoring the client's blood glucose levels Discussing the client's relationship with her father Identifying the client's personality type
Exploring the characteristics of the client's defense mechanisms
A client states that he is "paralyzed by guilt" because of his sexual thoughts. Further assessment reveals that the thoughts consume nearly all of the client's energy and time. Which action would be most appropriate for the nurse to do? Facilitate interventions that address the client's obsessions Reassure the client that the compulsions experienced are treatable Educate the client about strategies for managing the compulsions Present alternatives to the client's rituals
Facilitate interventions that address the client's obsessions
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.
A client is diagnosed with obsessive-compulsive disorder. Which of the following should be included in the plan of care for this client? Giving the client time to perform rituals Setting strict limits on compulsive behavior Increasing environmental stimulation Preventing ritualistic behavior
Giving the client time to perform rituals
The nurse is assisting a client with obsessive-compulsive disorder (OCD) during a behavior therapy session. How does the nurse assist the client with "response prevention"? Select all that apply. Assist the client to confront situations that increase anxiety. Help the client to accept thoughts and related anxiety. Teach that anxiety will recede without disastrous consequences. Assist the client to take charge of thoughts and manage anxiety. Inform the client that the disorder is hereditary.
Help the client to accept thoughts and related anxiety. Teach that anxiety will recede without disastrous consequences. Assist the client to take charge of thoughts and manage anxiety.
A nurse is providing care to several clients with obsessive-compulsive disorder. Which client would the nurse identify as most likely to benefit from psychosurgery? a client whose obsessive-compulsive disorder consumes most of the day's waking hours a client who has pulled out most of her hair and compulsively pulls on her eyelashes a client who has filled many of the rooms in his home with items that his family deems "trash" a client who picks at her skin compulsively and has frequently caused herself to bleed Psychosurgery is an option for severe OCD but is not typically used for the treatment of trichotillomania, hoarding, or skin-picking disorder.
Psychosurgery is an option for severe OCD but is not typically used for the treatment of trichotillomania, hoarding, or skin-picking disorder.
When a client with extremely severe obsessive-compulsive disorder (OCD) is no longer responding to intensive drug therapy or behavioral therapy, what other treatment options should the nurse prepare to educate the client/family about? Select all that apply. Stereotactic surgical procedures Deep-brain stimulation with electrical current Biofeedback techniques Service and companion dogs Hypnotherapy
Stereotactic surgical procedures Deep-brain stimulation with electrical current
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? Be 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.
Take up more than 1 hour/day and cause stress to the client.
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
The psychiatric mental health nurse is performing a suicide assessment of a client who has obsessive-compulsive disorder (OCD). What data should the nurse prioritize in order to maximize the accuracy of this assessment? The amount of psychological distress that the client's compulsions cause The degree of insight into the disorder that the client possesses The client's current medication regimen The client's recent adherence to prescribed treatment
The amount of psychological distress that the client's compulsions cause
The psychiatric mental health nurse is preparing to interview a new client. What assessment finding should prompt the nurse to assess the client for signs and symptoms of obsessive-compulsive disorder? The client has a diagnosis of dependent personality disorder The client made a suicide attempt several years earlier The client's mother has been hospitalized for treatment of depression The client is dressing inappropriately for the weather
The client has a diagnosis of dependent personality disorder
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
The client reports increased quality and quantity of sleep
The nurse is planning the care of a client who has been referred for the treatment of trichotillomania. What outcome should the nurse prioritize when planning care? The client will demonstrate healthy skills for coping with anxiety The client will demonstrate the ability to block obsessive thoughts The client will maintain adequate skin integrity The client will adhere to benzodiazepine therapy
The client will demonstrate healthy skills for coping with anxiety
The client has shown much improvement for obsessive-compulsive disorder (OCD). Which would be appropriate outcomes for a client with OCD? Select all that apply. The client will stop engaging in the compulsive activity. The client will spend less time performing rituals. The client will complete daily routine activities within a realistic time frame. The client will conceal the behavior from all persons to avoid anxiety. The client will demonstrate effective use of behavior therapy techniques.
The client will spend less time performing rituals. The client will complete daily routine activities within a realistic time frame. The client will demonstrate effective use of behavior therapy techniques.
The nursing student correctly identifies that which statements are true of the etiology of obsessive-compulsive disorder (OCD)? Select all that apply. The cognitive model for OCD etiology focuses on childhood and environmental experiences of growing up. The etiology of OCD is not definitively explained at this time. OCD is caused by immune dysfunction. The primary etiology of OCD is genetics. Cognitive models may partially explain why people develop OCD.
The etiology of OCD is not definitively explained at this time. The cognitive model for OCD etiology focuses on childhood and environmental experiences of growing up. Cognitive models may partially explain why people develop OCD.
Which are features of the thinking of a person who has obsessive-compulsive disorder (OCD), according to the cognitive model? Select all that apply. The person with OCD employs a minimalist approach to all aspects of his or her life. The person with OCD believes one's thoughts are overly important and has a need to control those thoughts as they overestimate the threat posed by their thoughts. The person with OCD is always aware that his or her behavior is related to OCD. The person with OCD is concerned with perfectionism and has an intolerance of uncertainty. The person with OCD has an inflated personal responsibility.
The person with OCD believes one's thoughts are overly important and has a need to control those thoughts as they overestimate the threat posed by their thoughts. The person with OCD is concerned with perfectionism and has an intolerance of uncertainty. The person with OCD has an inflated personal responsibility.
New research by Singh and Jones (2013) found that clients diagnosed with hoarding may benefit from which of the following? Increased regular dose of an antianxiety medication Using a "buddy" system where members support each other outside the group Daily visits from a social worker trained to perform hypnosis Waste treatment companies stopping by to offer their services at a reduced
Using a "buddy" system where members support each other outside the group
A client has been receiving medications and supportive therapy for the outpatient treatment of obsessive-compulsive disorder. When asked about the effect of treatment on the rituals, the client is vague and noncommittal. Which action would the nurse do next? consult with the client's family. administer a Mini Mental Status Examination (MMSE) collaborate with other members of the interdisciplinary team. assess the client's symptoms using the CAGE Questionnaire
consult with the client's family.
The psychiatric mental health nurse has taught a client with obsessive-compulsive disorder (OCD) about the use of cue cards. This intervention will allow the client to: counter obsessive thinking with positive messages. review the negative consequences of compulsive rituals. understand the relationship between obsessions and compulsions. review his or her daily goals.
counter obsessive thinking with positive messages.
A nurse is caring for a client with obsessive-compulsive disorder who continually checks appliances to be sure the appliances are turned off. Which areas should the nurse address in the plan of care? Select all that apply. an alternative activity such as cleaning the kitchen skin care measures to prevent skin breakdown relaxation techniques such as deep breathing cognitive restructuring for dysfunctional thoughts thought stopping when having obsessional thoughts
relaxation techniques such as deep breathing cognitive restructuring for dysfunctional thoughts thought stopping when having obsessional thoughts
The advanced practice psychiatric nurse is teaching thought stopping techniques to a client with obsessive-compulsive disorder (OCD). When providing this educational intervention, the nurse should: teach the client how to identify and interrupt obsessional thinking. teach the client how to gradually reduce the duration and intensity of compulsions teach the client to repeat positive messages. encourage the client to reflect critically on the consequences of compulsive behavior.
teach the client how to identify and interrupt obsessional thinking.