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Before eating a meal, a client with obsessive/compulsive disorder must wash her hands for 14 minutes, comb her hair for 114 strokes, and switch the light off and on 44 times. When evaluating the progress of the client, what is the most important treatment objective for this client?
- A. Allow ample time for completion of all rituals before each meal.
- B. Gradually decrease the amount of time spent for performing rituals.
- C. Increase the client's acceptance of the need for medication to control rituals.
- D. Omit one ritualistic behavior every 4 days until all rituals are eliminated.
Correct Answer: B
Rationale: Gradually reducing ritual time is key to restoring functional daily routines, unlike allowing full rituals, focusing solely on medication, or abrupt ritual elimination.
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Which of the following is the desired outcome for a client with OCD?
- A. That the client will no longer experience any signs or symptoms of OCD
- B. That the client will no longer experience anxiety
- C. That the OCD symptoms no longer interfere with the client's responsibilities
- D. To relieve the client with OCD of any responsibilities
Correct Answer: C
Rationale: The desired outcome is that OCD symptoms no longer disrupt responsibilities, allowing manageable anxiety, unlike expecting complete symptom elimination or responsibility removal.
Which of the following statements about the typical history of illness that would be assessed in a client who has OCD is consistent with OCD?
- A. OCD usually requires hospitalization.
- B. OCD treatment is usually outpatient.
- C. OCD only affects the client's ability to perform ADLs and work, not his or her leisure life.
- D. Most people seek treatment as soon as they observe the symptoms.
Correct Answer: B
Rationale: OCD treatment is typically outpatient, as hospitalization is rare unless rituals severely disrupt daily life, which includes work, ADLs, and leisure; most delay seeking treatment.
Which of the following are important for the nurse to remember when teaching relaxation and behavioral techniques to a client with OCD?
- A. It is important to teach the client to use relaxation techniques when the client's anxiety is low.
- B. The nurse may teach the client about relaxation techniques when the client is experiencing anxiety.
- C. The client must be willing to engage in exposure and response prevention.
- D. The client must be forced to use relaxation techniques.
- E. It is unnecessary to assess the baseline of ritualistic behaviors in the client with OCD.
Correct Answer: A,B,C
Rationale: Teaching relaxation when anxiety is low or during anxiety, and ensuring willingness for exposure and response prevention, are key, but forcing techniques or skipping baseline assessments is inappropriate.
A client with OCD is admitted to the psychiatric unit. Which of the following would be most appropriate for the nurse to include in the client's care plan?
- A. Allow time for the client to perform needed rituals.
- B. Immediately stop the client from performing rituals.
- C. Teach the client that the rituals are not necessary.
- D. Distract the client with other activities whenever rituals are performed.
Correct Answer: A
Rationale: Allowing time for rituals reduces anxiety and supports the client's sense of security, unlike immediate cessation or distraction, which may increase distress.
Which of the following is essential for the nurse to communicate to the client with OCD and to the client's family?
- A. The client's diagnosis should be kept secret from everyone outside the immediate family and friends.
- B. The importance of medication compliance and that it may be necessary for medication to be changed to find the one that works best.
- C. It is important for the client to avoid following a routine.
- D. It is helpful for others to give unsolicited advice about other activities the client with OCD can engage in.
Correct Answer: B
Rationale: Emphasizing medication compliance and potential adjustments is crucial for effective OCD management, unlike secrecy, avoiding routines, or unsolicited advice, which are counterproductive.