Nokea
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.
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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 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.
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.
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.
The nurse correctly identifies that which of OCDs self-soothing behaviors may involve self-destruction of the body of a person who has OCD?
- A. Dermatillomania
- B. Trichotillomania
- C. Onychophagia
- D. Kleptomania
- E. Oniomania
Correct Answer: A,B,C
Rationale: Dermatillomania (skin-picking), trichotillomania (hair-pulling), and onychophagia (nail-biting) are self-soothing behaviors causing physical harm, unlike kleptomania or oniomania, which are reward-seeking.