A client with obsessive-compulsive disorder (OCD) spends hours each day washing her hands. Which intervention should the nurse implement to help the client reduce this behavior?
- A. Encourage the client to set a time limit for washing hands.
- B. Encourage the client to wash hands only when necessary.
- C. Encourage the client to use hand sanitizer instead of washing.
- D. Encourage the client to explore the reasons behind the hand washing.
Correct Answer: A
Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.
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A client with borderline personality disorder is admitted to the psychiatric unit. Which intervention should the nurse implement to promote the client's safety?
- A. Implement a no-harm contract with the client.
- B. Monitor the client closely for signs of self-harm.
- C. Encourage the client to participate in recreational activities.
- D. Encourage the client to maintain a structured daily routine.
Correct Answer: A
Rationale: When a client with borderline personality disorder is admitted to a psychiatric unit, implementing a no-harm contract is a crucial intervention to promote the client's safety. A no-harm contract is a formal agreement between the client and the healthcare provider stating that the client commits to not harm themselves or others. This intervention helps in establishing boundaries and promoting safety by enhancing communication and accountability between the client and the healthcare team. Monitoring the client closely for signs of self-harm (Choice B) is important but does not directly address promoting safety through a formal agreement. Encouraging participation in recreational activities (Choice C) and maintaining a structured daily routine (Choice D) are beneficial interventions but may not directly address the immediate safety concerns of a client with borderline personality disorder.
A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates a need for further teaching?
- A. I should avoid driving while taking this medication.
- B. I can stop taking this medication abruptly if I feel better.
- C. It may take several weeks for this medication to take effect.
- D. I should avoid using this medication during pregnancy.
Correct Answer: B
Rationale: The correct answer is B. Clients should not stop taking buspirone (Buspar) abruptly as it may cause withdrawal symptoms. Choice A is correct as buspirone can cause dizziness and drowsiness, so avoiding driving is important. Choice C is also accurate because buspirone may take several weeks to reach its full effectiveness. Choice D is valid as buspirone is not recommended during pregnancy due to potential risks to the fetus.
A client diagnosed with post-traumatic stress disorder (PTSD) is being assessed by a healthcare professional. Which symptom would the healthcare professional expect the client to exhibit?
- A. Delusions of grandeur
- B. Hypervigilance
- C. Obsessive-compulsive behaviors
- D. Periods of excessive sleeping
Correct Answer: B
Rationale: In individuals with post-traumatic stress disorder (PTSD), hypervigilance is a common symptom. Hypervigilance refers to a state of increased alertness, awareness, and sensitivity to potential threats or danger. This heightened state of vigilance can manifest as being easily startled, having difficulty relaxing or sleeping, and constantly scanning the environment for signs of danger. It is an adaptive response to the trauma experienced and can significantly impact the individual's daily functioning. The other options are not typically associated with PTSD. Delusions of grandeur are more commonly seen in certain psychiatric disorders like bipolar disorder or schizophrenia. Obsessive-compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not PTSD. Periods of excessive sleeping may be seen in conditions like depression, but they are not a hallmark symptom of PTSD.
A client is prescribed lorazepam (Ativan) for the management of anxiety. Which statement by the client indicates the need for further teaching?
- A. I should take this medication at the same time every day.
- B. I can drink alcohol while taking this medication.
- C. I should avoid driving while taking this medication.
- D. I should avoid using this medication during pregnancy.
Correct Answer: B
Rationale: The correct answer is B. Clients should avoid alcohol while taking lorazepam (Ativan) due to potential interactions. Alcohol can increase the side effects of lorazepam, such as drowsiness and dizziness, which can be dangerous, especially when combined with activities like driving or operating machinery. Choice A is correct as it promotes medication adherence. Choice C is correct as lorazepam can impair cognitive and motor skills, impacting driving ability. Choice D is correct as lorazepam is not recommended during pregnancy due to potential harm to the fetus.
A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?
- A. I can stop taking this medication once I feel less anxious.
- B. I should avoid drinking alcohol while taking this medication.
- C. It may take several weeks for this medication to take full effect.
- D. This medication can cause dependency.
Correct Answer: A
Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.