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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Choice C rationale:
Risperidone is an atypical antipsychotic medication that is sometimes used as an augmentation strategy in treating OCD, particularly in cases where there are prominent obsessive-compulsive symptoms that are not well-controlled by other interventions. However, it's important to note that risperidone's use in OCD is off-label, meaning it's not approved by regulatory agencies specifically for OCD treatment.
Choice D rationale:
Selective serotonin reuptake inhibitors (SSRIs) are a cornerstone of pharmacological treatment for OCD. These medications, such as fluoxetine, sertraline, and fluvoxamine, increase the availability of serotonin in the brain and help alleviate obsessive-compulsive symptoms. They have been extensively studied and are considered first-line treatment options.
Choice A rationale:
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat depression and anxiety disorders. While it may have some benefit for anxiety symptoms, including those related to OCD, it is not considered a first-line treatment for OCD. SSRIs have shown greater efficacy for OCD management.
Choice B rationale:
Tricyclic antidepressants (TCAs) were among the first medications used to treat OCD. However, their side effect profiles and the availability of more effective and better-tolerated options, such as SSRIs, have led to TCAs being used less frequently for OCD treatment.
Choice E rationale:
Dopamine agonists are not commonly used for OCD treatment. In fact, they can potentially exacerbate symptoms, as imbalances in dopamine transmission are implicated in the pathophysiology of OCD. Using dopamine agonists without a clear rationale could worsen the condition.
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale:
While fear of heights and open spaces leading to avoidance behaviors can be associated with anxiety disorders, it is not a typical theme for obsessions and compulsions in individuals with OCD. OCD themes usually revolve around repetitive thoughts and behaviors that aim to alleviate distress or prevent feared outcomes.
Choice B rationale:
The repeated checking of the stove being turned off before leaving the house is a common obsession and compulsion in individuals with OCD. This behavior stems from the fear of potential harm or danger (e.g., fire) and the compulsive act of checking is performed to reduce anxiety related to the obsession.
Choice C rationale:
Feeling the need to touch every object in a room an equal number of times is another manifestation of OCD. This behavior is driven by the obsession of achieving symmetry, balance, or a sense of completeness through compulsive rituals like touching.
Choice D rationale:
Persistent worry about a loved one's safety causing ritualistic prayers is also a theme seen in OCD. Individuals may feel compelled to engage in repetitive prayers or rituals to protect their loved ones from harm due to their obsessive fears.
Choice E rationale:
The strong desire to organize items by color, shape, and size is more indicative of perfectionism or certain personality traits rather than a typical theme in OCD. OCD usually involves distressing and unwanted thoughts (obsessions) and the corresponding rituals or repetitive behaviors (compulsions) aimed at reducing the distress.
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