Nokea
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.
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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.
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.
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.
Which of the following are features of the thinking of a person who has OCD according to the cognitive model?
- A. The person with OCD employs a minimalist approach to all aspects of his or her life.
- B. The person with OCD believes one's thoughts are overly important and has a need to control those thoughts as they overestimate the threat posed by their thoughts.
- C. The person with OCD is always aware that his or her behavior is related to OCD.
- D. The person with OCD is concerned with perfectionism and has an intolerance of uncertainty.
- E. The person with OCD has an inflated personal responsibility
Correct Answer: B,D,E
Rationale: OCD thinking involves overestimating thought importance, perfectionism, intolerance of uncertainty, and inflated responsibility, but not minimalism or constant awareness of OCD-related behavior.