A nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD) Which statement by the client indicates an obsession?

Choice A rationale:

Family history of OCD is a significant risk factor for developing the disorder. Genetic predisposition plays a role in the etiology of OCD, with a higher likelihood of the disorder occurring in individuals who have close relatives (e.g., parents or siblings) with the condition. While environmental factors and life experiences can contribute to OCD, they are not as directly linked as the genetic component.

Choice B rationale:

History of childhood trauma can contribute to the development of various mental health disorders, including anxiety and OCD. However, the strongest association with OCD is the genetic component. While childhood trauma can exacerbate symptoms in individuals who are genetically predisposed, it is not the most likely finding in the medical record of a client with OCD.

Choice C rationale:

Head injury can lead to neurological and psychological changes, potentially contributing to various psychiatric conditions. However, the primary cause of OCD is not head injury. It is important to consider the presence of other factors, especially the genetic predisposition, when attributing OCD to a particular cause.

Choice D rationale:

Brain tumor is an organic condition that can cause neurological and psychological symptoms. However, brain tumors are not a common or primary cause of OCD. The focus in the etiology of OCD is on neurotransmitter imbalances, genetic factors, and brain circuitry, rather than structural brain abnormalities like tumors.

Choice A rationale:

The statement "I always arrange my books on the shelf from tallest to shortest" doesn't indicate an obsession. This behavior might suggest a preference for orderliness or arranging things systematically, but it lacks the distressing, unwanted nature of obsessions.

Choice B rationale:

"I feel an overwhelming urge to wash my hands every 30 minutes" indicates a compulsion rather than an obsession. The urge to wash hands frequently is driven by the need to alleviate anxiety or distress, which is the hallmark of compulsive behaviors.

Choice C rationale:

"I have a ritual of counting to 10 before entering any room" is also a compulsion. The ritual of counting serves as a way to reduce anxiety or prevent a feared outcome associated with entering a room, suggesting a compulsive behavior.

Choice D rationale:

The statement "I keep having thoughts that my family will get hurt if I don't touch the doorknob three times" reflects an obsession. The distressing thought of family harm is the unwanted obsession, and the ritual of touching the doorknob three times is the compulsion aimed at reducing the anxiety caused by the obsession.