A nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD) Which statement by the client indicates an obsession?
"I always arrange my books on the shelf from tallest to shortest.”
"I feel an overwhelming urge to wash my hands every 30 minutes.”
"I have a ritual of counting to 10 before entering any room.”
"I keep having thoughts that my family will get hurt if I don't touch the doorknob three times.”
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Taking the SSRI in the morning might be recommended to mitigate potential sleep disturbances related to the medication. However, the client's reported difficulty sleeping is likely influenced by factors beyond the timing of medication administration.
Choice B rationale:
The correct response addresses lifestyle modifications that can improve sleep quality. Caffeine and alcohol are known to disrupt sleep, especially when taken close to bedtime. Avoiding these substances can promote better sleep for the client.
Choice C rationale:
Regular exercise can indeed contribute to improved sleep, but its effect might vary for individuals. While exercise can be part of a healthy routine, it might not directly address the client's reported difficulty sleeping due to the SSRI.
Choice D rationale:
Taking a warm bath before bed can promote relaxation and potentially aid in sleep, but it might not be as effective in resolving the client's specific sleep problems related to SSRI use.
Correct Answer is B
Explanation
Choice A rationale:
Teaching the client about the history of OCD might provide insight into the disorder's background, but it is not the priority when the client is currently experiencing distress. Addressing the immediate distress takes precedence over historical information.
Choice B rationale:
This choice is correct because relaxation techniques can help alleviate the client's distress in the moment. These techniques, such as deep breathing, progressive muscle relaxation, or mindfulness exercises, can help the client manage their anxiety and reduce the impact of obsessive thoughts.
Choice C rationale:
While providing information about medication options is important, it might not be the initial intervention when the client is in a state of distress. Medication discussions are typically part of a comprehensive treatment plan and should be addressed after addressing the client's immediate distress.
Choice D rationale:
Initiating exposure therapy sessions might exacerbate the client's distress at this point. Exposure therapy involves deliberately confronting feared situations, and it's important to prepare the client for this type of intervention before initiating it. Starting with relaxation techniques is a more appropriate approach.
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