A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?

The client will substitute a productive activity for mats by day one

The client will refrain from ritualistic behaviors during daylight hours.

The client will participate in the unit activities by day three

The Client will wake early enough to complete rituals prior to breakfast

Answer and Explanation

The Correct Answer is B

A. The client will substitute a productive activity for rituals by day one: This outcome may be challenging to achieve within the first day, and it is important to set realistic goals. Moreover, focusing on substituting a productive activity might not address the immediate need to reduce ritualistic behaviors.

B. The client will refrain from ritualistic behaviors during daylight hours: This is an appropriate initial outcome. It acknowledges the challenge of completely eliminating rituals but sets a realistic goal of refraining from these behaviors during daylight hours. This allows for gradual progress without setting unrealistic expectations.

C. The client will participate in unit activities by day three: While participation in unit activities is a positive goal, it may be too optimistic to expect this within the first three days, especially considering the severity of obsessive-compulsive disorder symptoms.

D. The client will wake early enough to complete rituals prior to breakfast: This goal does not promote a reduction in ritualistic behaviors; instead, it may reinforce and accommodate the rituals. The aim of treatment for obsessive-compulsive disorder is to reduce the impact of these rituals, not to support them.

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Correct Answer is C

Explanation

Individuals with OCD often engage in compulsive behaviors, such as repetitive cleaning, as a way to alleviate or decrease anxiety associated with obsessive thoughts. In the context of OCD, obsessions are intrusive and distressing thoughts, images, or urges that cause significant anxiety, while compulsions are repetitive behaviors or mental acts performed in response to the obsessions.

A. Decrease the time available for interaction with people:

While individuals with OCD may isolate themselves due to their symptoms, the primary motivation for repetitive behaviors like cleaning is to manage anxiety, not necessarily to avoid interaction with others.

B. Prevent aggressive and impulsive behaviors:

OCD compulsions are not typically aimed at preventing aggressive or impulsive behaviors. They are driven by the need to reduce distress related to obsessive thoughts.

C. Decrease anxiety:

This is the correct answer. Compulsive behaviors in OCD are often ritualistic actions performed to reduce the anxiety associated with obsessive thoughts. Cleaning, in this case, is a way for the individual to feel a sense of control and alleviate anxiety.

D. Manipulate others

The primary motive behind OCD compulsions is to manage personal anxiety, not to manipulate others. Individuals with OCD often recognize that their compulsions are excessive or irrational, but they feel driven to perform them to alleviate anxiety.

A. Disturbed sensory perception B. Risk for violence: directed toward others C. Altered thought processes D. Risk for injury

Correct Answer is B

Explanation

A. Disturbed sensory perception: While the client is experiencing disturbed sensory perception (auditory hallucinations), the priority is to address the potential harm to others, which is better captured by the "Risk for violence: directed toward others" diagnosis.

B. Risk for violence: directed toward others: This diagnosis is the priority in this situation because the client is expressing homicidal thoughts directed toward a specific target (the president). Ensuring the safety of the client and others is the primary concern.

C. Altered thought processes: Altered thought processes may be evident in psychotic disorders, but the immediate concern is the risk of violence. Addressing altered thought processes would be part of the overall care plan, but it may not be the immediate priority in this case.

D. Risk for injury: While the client may be at risk for injury, the specific concern mentioned by the client is the potential harm to others (the president). Therefore, the "Risk for violence: directed toward others" diagnosis takes precedence.

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A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and finds that the client demonstrates constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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