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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.
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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 is an important part of therapeutic communication for clients who have OCD?
- A. To encourage the client to keep the obsession secret.
- B. To encourage the client to discuss his or her obsession with the nurse.
- C. The nurse must have the same obsession as the client.
- D. The nurse must instruct the client to discuss the obsession.
Correct Answer: B
Rationale: Encouraging discussion of obsessions fosters therapeutic trust and insight, unlike secrecy, shared obsessions, or mandating discussion, which are not therapeutic.
Which of the following treatment modalities is most effective for OCD?
- A. Behavioral techniques
- B. Medication
- C. Behavioral techniques and medication
- D. Ignoring it
Correct Answer: C
Rationale: Combining behavioral techniques and medication is most effective for managing OCD symptoms, as neither alone is sufficient, and ignoring it exacerbates the condition.
Which of the following interventions by the nurse will increase the client's sense of security?
- A. Allowing the client to perform the rituals
- B. Distracting the client from rituals with other activities
- C. Encouraging the client to talk about the purpose of the rituals
- D. Stopping the client from performing the rituals
Correct Answer: A
Rationale: Allowing rituals reduces anxiety, enhancing the client's sense of security, unlike distraction or stopping rituals, which may escalate distress.
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.