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The nurse is caring for her first client with obsessive/compulsive disorder. During the treatment team meeting, the nurse shares her frustration as to the client's inability to stop washing his hands. The nurse manager offers which one of the following explanations?
- A. The hand washing represents a way to exert independence from the staff.
- B. The client is not aware of the excessive hand washing.
- C. The client does not think anything is abnormal with washing his hands repeatedly.
- D. The client feels terrible but cannot stop washing his hands to try to get rid of his anxiety.
Correct Answer: D
Rationale: The client's compulsive hand washing is driven by anxiety relief, not independence, unawareness, or denial of abnormality, as rituals are an attempt to manage overwhelming anxiety.
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The nurse is providing education to a group of persons from several community agencies about hoarding by elder persons. Which of the following is important for the nurse to emphasize?
- A. Treatment will likely start to be effective in the short term.
- B. If the person had help to clean up his or her environment, the hoarding would be cured.
- C. It is not beneficial to tell the client that his or her thoughts and rituals interfere with his or her life or that his or her ritual actions really have no lasting effect on anxiety.
- D. One agency should be able to address all of the client's needs.
Correct Answer: C
Rationale: Avoiding criticism of hoarding behaviors prevents shame and supports treatment, as short-term fixes, cleanups, or single-agency solutions are ineffective.
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.
The student nurse correctly identifies that which of the following are characteristics of hoarding disorder?
- A. Excessive acquisition of animals or apparently useless things
- B. Cluttered living spaces that become uninhabitable
- C. Significant distress or impairment for the individual
- D. Disposing of articles that are of no value
Correct Answer: A,B,C
Rationale: Hoarding disorder involves excessive acquisition, cluttered uninhabitable spaces, and significant distress or impairment, but not disposing of valueless items, which contradicts hoarding behavior.
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.
The nursing student correctly identifies which of the following statements are true of the etiology of OCD?
- A. The cognitive model for OCD etiology focuses on childhood and environmental experiences of growing up.
- B. The etiology of OCD is not definitively explained at this time.
- C. OCD is caused by immune dysfunction.
- D. The primary etiology of OCD is genetics.
- E. Cognitive models may partially explain why people develop OCD.
Correct Answer: A,B,E
Rationale: The cognitive model highlights childhood and environmental influences, and partially explains OCD, but the etiology remains unclear, with genetics and immune dysfunction as contributing, not sole, factors.