Nokea
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.
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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.
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.
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.
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.
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.