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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.
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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 student nurse correctly identifies that which one of the following statements is true regarding clients with OCD?
- A. Since the client is aware that his or her behavior is bizarre, the client should just stop the behavior.
- B. Clients with OCD seem normal on the outside but suffer from overwhelming fear and anxiety.
- C. Once a person is successfully treated for OCD, he or she has been cured.
- D. Persons with OCD must avoid stress.
Correct Answer: B
Rationale: Clients with OCD often appear normal but experience significant internal anxiety, unlike assumptions of easy behavior cessation, permanent cures, or complete stress avoidance.
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.
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 would be appropriate outcomes for a client with OCD?
- A. The client will stop engaging in the compulsive activity.
- B. The client will spend less time performing rituals.
- C. The client will complete daily routine activities within a realistic time frame.
- D. The client will conceal the behavior from all persons to avoid anxiety.
- E. The client will demonstrate effective use of behavior therapy techniques.
Correct Answer: B,C,E
Rationale: Appropriate outcomes include reduced ritual time, completing daily activities realistically, and using behavior therapy effectively, but not completely stopping rituals or concealing behaviors.