A nurse is caring for a client with OCD who is experiencing an anxiety attack. The client is saying, "I have to wash my hands! I have to wash my hands!" Which of the following responses should the nurse make?
"It's okay, you don't have to wash your hands.”
"I understand that you're feeling anxious. Let's talk about what's going on.”
"You need to calm down and stop thinking about washing your hands.”
"I'll help you wash your hands.”
The Correct Answer is B
Choice A rationale:
Telling the client "It's okay, you don't have to wash your hands" might invalidate the client's feelings and fears, leading to increased anxiety. The client's compulsion to wash their hands is driven by their obsessive thoughts, and dismissing this behavior can be counterproductive.
Choice B rationale:
The correct response acknowledges the client's anxiety and opens a conversation about their feelings. This approach helps build a therapeutic relationship and provides an opportunity for the client to express their concerns. It's essential to address the underlying anxieties associated with OCD to promote better coping strategies.
Choice C rationale:
Telling the client to "calm down and stop thinking about washing your hands" oversimplifies the situation. People with OCD often struggle with controlling their obsessive thoughts and compulsions, and such a directive can be ineffective and frustrating for the client.
Choice D rationale:
Offering to "help you wash your hands" reinforces the client's compulsion rather than addressing the root cause of their anxiety. Enabling their compulsive behavior can contribute to the maintenance of their OCD symptoms.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The limbic circuit consisting of the hippocampus, amygdala, and hypothalamus is not the main brain circuit involved in obsessive-compulsive disorders (OCDs) The limbic circuit is more closely associated with emotions and memory, rather than the cognitive processes that drive OCD symptoms.
Choice B rationale:
The central executive circuit comprising the prefrontal cortex and temporal lobes is responsible for higher-level cognitive functions like decision-making and working memory. However, this circuit is not primarily implicated in the pathophysiology of OCD.
Choice C rationale:
The correct choice. The cortico-striato-thalamo-cortical (CSTC) circuit plays a central role in the development of OCD. This circuit involves several key components: Orbitofrontal cortex: Responsible for assessing potential risks and rewards, and for decision-making. Anterior cingulate cortex: Involved in error detection, emotional processing, and regulating cognitive flexibility. Striatum: Responsible for habit formation and reward-based learning. Thalamus: Acts as a relay station for information between various brain regions. This circuit's malfunction can lead to repetitive behaviors and intrusive thoughts characteristic of OCD.
Choice D rationale:
The ventral tegmental circuit involving the substantia nigra and ventral tegmental area is primarily associated with the brain's reward system and the regulation of mood and motivation. It is not a key player in OCD's pathophysiology.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale:
Obsessions and compulsions are aimed at reducing anxiety or distress. This statement accurately describes a characteristic of obsessive-compulsive disorder (OCD) Obsessions are intrusive and unwanted thoughts, images, or urges that cause significant distress, while compulsions are repetitive behaviors or mental acts aimed at reducing the distress caused by the obsessions. These behaviors are performed in response to the distress and are intended to alleviate it. For example, if someone has an obsession about contamination, their compulsion might involve excessive hand washing to alleviate the anxiety associated with the obsession.
Choice B rationale:
Obsessions and compulsions are consistent with the individual's self-image. This statement is not accurate in differentiating OCD from other mental disorders. Obsessions and compulsions in OCD often involve themes that are inconsistent with the individual's self-image and are not representative of their true desires or intentions. For instance, someone with OCD might have obsessions about harming others, even if they have no actual desire to do so. These obsessions are not aligned with their self-image.
Choice C rationale:
The individual recognizes that obsessions and compulsions are irrational. This statement accurately describes another characteristic of OCD. People with OCD typically recognize that their obsessions and compulsions are irrational and unreasonable, but they feel compelled to engage in these behaviors to alleviate anxiety. This recognition of the irrational nature of their thoughts and actions is a distinguishing feature of OCD, differentiating it from other disorders where the person might not have such insight into the irrationality of their behaviors.
Choice D rationale:
Obsessions and compulsions may lead to positive emotional outcomes. This statement is not accurate in the context of OCD. Obsessions and compulsions are not aimed at achieving positive emotional outcomes. Instead, they are performed to reduce distress or anxiety. The relief gained from engaging in compulsions is temporary and often followed by a cycle of escalating compulsions to achieve the same level of relief, which contributes to the perpetuation of the disorder.
Choice E rationale:
Obsessions and compulsions cause impairment in daily functioning. This statement accurately describes another characteristic of OCD. The obsessions and compulsions associated with OCD can be time-consuming and interfere significantly with a person's daily activities, relationships, and overall quality of life. These behaviors can lead to impaired occupational and social functioning, making this statement a distinguishing feature of OCD.
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