A nurse is creating a plan of care for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following interventions should the nurse include?

Choice A reason:

Giving the client a cup of hot black tea before bed is not advisable. Black tea contains caffeine, which can interfere with sleep and exacerbate sleep disturbances. It is important to avoid stimulants before bedtime to promote better sleep quality.

Choice B reason:

Waking the client at the same time each morning helps establish a consistent sleep-wake cycle, which is beneficial for managing sleep disturbances. Regular wake times can help regulate the body’s internal clock and improve overall sleep patterns.

Choice C reason:

Taking the client for a walk 2 hours before bedtime can be beneficial as physical activity can promote better sleep. However, it is not as crucial as maintaining a consistent wake time, which directly influences the sleep-wake cycle.

Choice D reason:

Allowing the client to take a 90-minute nap immediately after lunch may interfere with nighttime sleep. Long naps during the day can reduce the drive to sleep at night, leading to further sleep disturbances.

Choice A reason:

A client with new-onset delirium is experiencing an acute and often fluctuating disturbance in attention and cognition. Delirium is typically caused by an underlying medical condition, substance intoxication, or withdrawal. Assertiveness training would not be appropriate for this client as the primary focus should be on identifying and treating the underlying cause of the delirium.

Choice B reason:

A client experiencing auditory hallucinations is likely dealing with a psychotic disorder such as schizophrenia. The primary treatment for such clients involves antipsychotic medications and psychotherapy aimed at managing symptoms and improving reality orientation. Assertiveness training is not suitable for clients in the acute phase of psychosis as their ability to engage in and benefit from such training is compromised.

Choice C reason:

A client experiencing mania, a state characterized by elevated mood, hyperactivity, and impulsive behavior, is typically seen in bipolar disorder. During a manic episode, the client may have difficulty focusing and controlling their impulses, making it challenging to participate effectively in assertiveness training. The priority for these clients is to stabilize their mood with medication and supportive therapy.

Choice D reason:

A client with somatic symptom disorder experiences excessive thoughts, feelings, and behaviors related to physical symptoms. Assertiveness training can be beneficial for these clients as it helps them express their needs and concerns more effectively, reducing the focus on physical symptoms and improving their overall functioning.