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?

Decrease the time available for interaction with people

Prevent aggressive and impulsive behaviors

Decrease anxiety.

Manipulate others

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is A

Explanation

A. By using a screening tool such as the CAGE questionnaire: This is the correct answer. The CAGE questionnaire is a widely used tool for screening alcohol use disorders. It consists of four questions that assess whether the individual has concerns or issues related to their alcohol consumption. A positive result may indicate a need for further assessment and intervention.

B. By asking directly if the client has ever had a problem with alcohol: While direct questioning is important, using a structured screening tool provides a more standardized and objective approach. The CAGE questionnaire offers specific questions that help identify potential issues with alcohol use.

C. By holistically assessing the client using the CINA scale: The CINA scale (Checklist of Nonverbal Indicators of Affect) is primarily used to assess nonverbal behaviors related to affect. While it may be useful in certain contexts, it is not specifically designed for assessing alcohol use disorders.

D. By referring the client for physician evaluation: While physician evaluation may be necessary for a comprehensive assessment, using a screening tool such as the CAGE questionnaire is an appropriate initial step. The results of the screening tool can guide further assessment and appropriate referrals.

A. Maintain consistency of care by open communication to avoid staff manipulation B. Maintain unit order by the application of autocratic leadership C. Allow the clients to apply the democratic process when developing unit rules D. Allow the client spokesperson to verbalize concerns during a unit staff meeting

Correct Answer is A

Explanation

A. Maintain consistency of care by open communication to avoid staff manipulation: This is the correct answer. Borderline personality disorder (BPD) clients may engage in splitting behaviors, which involve polarized views of staff as either all good or all bad. Maintaining consistency of care and open communication can help prevent manipulation and ensure fair and transparent interactions.

B. Maintain unit order by the application of autocratic leadership: Autocratic leadership, characterized by a top-down approach with limited input from others, may not be the most effective strategy in this situation. It may lead to resistance from clients and potentially escalate the conflict.

C. Allow the clients to apply the democratic process when developing unit rules: While democratic processes are generally beneficial, allowing clients to unreasonably demand modifications of unit rules without considering the overall impact on the therapeutic environment may not be appropriate. It's important to balance client involvement with maintaining a structured and therapeutic milieu.

D. Allow the client spokesperson to verbalize concerns during a unit staff meeting: While it's important to provide a platform for clients to express concerns, allowing a spokesperson to verbalize concerns during a staff meeting should be done in a manner that maintains order and follows the therapeutic goals of the unit. It should not involve unreasonably demanding modifications without a careful consideration of the impact on the overall treatment milieu.

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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?

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