A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?
- A. Discuss alternative coping strategies with the client.
- B. Identify precipitating factors for ritualistic behaviors.
- C. Instruct the client on relaxation techniques for use when anxiety increases.
- D. Provide a structured activity schedule for the client.
Correct Answer: B
Rationale: The correct answer is B: Identify precipitating factors for ritualistic behaviors. This is the first action the nurse should take because understanding the triggers for the client's ritualistic behaviors is essential in developing an effective care plan. By identifying these factors, the nurse can work with the client to address them and potentially reduce the frequency or intensity of the OCD symptoms. Discussing coping strategies (choice A), teaching relaxation techniques (choice C), and providing a structured activity schedule (choice D) are important interventions but should come after identifying the triggers to ensure they are tailored to the individual's specific needs.
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Which medication is commonly prescribed to treat obsessive-compulsive disorder (OCD)?
- A. Paroxetine
- B. Lithium
- C. Donepezil
- D. Valproate
- E. Carbamazepine
Correct Answer: A
Rationale: The correct answer is A: Paroxetine. Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for OCD due to its effectiveness in increasing serotonin levels in the brain, which helps reduce obsessive thoughts and compulsive behaviors. Lithium, Donepezil, Valproate, and Carbamazepine are not typically used to treat OCD as they are more commonly indicated for conditions such as mood disorders, Alzheimer's disease, epilepsy, and bipolar disorder, respectively. Therefore, Paroxetine is the most appropriate choice for treating OCD based on its mechanism of action and proven efficacy.
A client who has coronary artery disease tells the nurse he is afraid of dying from a heart attack. Which of the following responses should the nurse make?
- A. "Perhaps you should discuss this with your physician."
- B. "Of course you aren't going to die, at least not in the immediate future."
- C. "I recommend you exercise daily and avoid smoking to decrease your risk."
- D. "Tell me more about these fears of dying from a heart attack."
Correct Answer: D
Rationale: Encouraging the client to talk about their fears fosters therapeutic communication.
Which action is most therapeutic for a client with panic-level anxiety?
- A. Suggest the client rest in bed
- B. Remain with the client
- C. Medicate the client with a sedative
- D. Have the client join a therapy group
Correct Answer: B
Rationale: The correct answer is B: Remain with the client. This is the most therapeutic action because it provides immediate reassurance and support to the client, helping to reduce feelings of isolation and fear during a panic attack. By staying with the client, you can offer comfort and help them feel safe and supported.
Choice A is incorrect as suggesting the client rest in bed may not address their immediate needs during a panic attack. Choice C, medicating the client with a sedative, may provide short-term relief but does not address the underlying causes of the anxiety. Choice D, having the client join a therapy group, is not suitable during a panic attack as the client needs immediate support and intervention.
A nurse is providing teaching to a client who has alcohol use disorder about Alcoholics Anonymous (AA). Which of the following client statements indicates an understanding of the program's basic concepts?
- A. "I am responsible for my alcoholism."
- B. "I need to identify things that cause me to be an alcoholic."
- C. "I am powerless against my addiction to alcohol."
- D. "I need to see a counselor who will be responsible for my recovery."
Correct Answer: C
Rationale: AA is based on the principle of acknowledging powerlessness over addiction and seeking support.
A nurse in the emergency department is caring for a client who reports chest pain, headache, and shortness of breath. He continues to state, “I don't know why my wife left me.” The client receives a diagnosis of anxiety. The nurse realizes the client’s findings support which level of anxiety?
- A. Mild
- B. Moderate
- C. Severe
- D. Panic
Correct Answer: D
Rationale: The correct answer is D: Panic. The client is experiencing severe physical symptoms (chest pain, headache, shortness of breath) and is unable to identify the source of his distress, which indicates a high level of anxiety. Panic level is characterized by overwhelming fear and physical symptoms that can mimic a heart attack. Mild anxiety (A) is characterized by minor discomfort, moderate anxiety (B) involves increased heart rate and muscle tension, and severe anxiety (C) includes more pronounced physical symptoms. In this case, the client's presentation aligns most closely with panic level anxiety.