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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.
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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.
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 the most important variable in determining the likelihood of success in improving life for a client with OCD?
- A. The client must be willing to make changes in his or her behavior.
- B. The client must acknowledge that the behavior is not in his or her control.
- C. The client must allow the nurse to decide the appropriate intervention for him or her.
- D. The client must be willing to try all new relaxation techniques.
Correct Answer: A
Rationale: The client's willingness to change behavior is critical for successful OCD management, unlike acknowledging lack of control or relying solely on nurse-directed interventions.
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.
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.