A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

A. Limit the amount of time available to interact with others. This statement does not align with the typical behavior of individuals with obsessive-compulsive disorder (OCD). While the client's behavior of constantly picking up after others may indirectly limit interaction time, the primary motivation behind this behavior is more likely related to managing anxiety rather than intentionally limiting social interaction.

B. Manipulate and control others' behaviors. While individuals with OCD may engage in behaviors that affect others, such as seeking reassurance or involving others in their rituals, the behavior described in the scenario does not appear to be aimed at manipulating or controlling others. Instead, it seems driven by the client's internal need to alleviate anxiety through compulsive actions.

C. Decrease anxiety to a tolerable level. This is the correct choice. People with OCD often engage in compulsive behaviors as a way to reduce distressing feelings of anxiety or discomfort. By picking up after others compulsively, the client may experience temporary relief from obsessive thoughts and the associated anxiety. However, the relief is typically short-lived and can lead to a cycle of compulsive behaviors.

D. Focus attention on meaningless tasks. While the behavior of constantly picking up after others may seem repetitive or meaningless to an observer, individuals with OCD typically attribute great significance to their compulsive actions. These behaviors are driven by the need to reduce anxiety or prevent perceived harm rather than a deliberate focus on meaningless tasks.

A. Plan the client's schedule to allow time for rituals: This is the most appropriate action. It is essential to recognize that compulsive behaviors in OCD serve as coping mechanisms for the individual. Allowing time for rituals within the client's schedule can help reduce anxiety and provide a sense of control. Gradual exposure and response prevention techniques can be incorporated into the treatment plan over time to help the client gradually decrease reliance on rituals.

B. Isolate the client for a period of time: Isolating the client may exacerbate feelings of anxiety and distress, as well as decrease opportunities for social interaction and support, which are essential components of mental health treatment.

C. Confront the client about the senseless nature of the repetitive behaviors: Confrontation may lead to defensiveness and resistance from the client. It is important to approach the client with empathy and understanding rather than judgment. Educating the client about the nature of OCD and the role of compulsive behaviors in managing anxiety can be more helpful in fostering insight and motivation for change.

D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules: Setting strict limits may increase the client's distress and resistance. It is important to collaborate with the client in treatment planning and find a balance between supporting the client's needs and maintaining a therapeutic environment. Gradual exposure and response prevention techniques should be implemented in a supportive manner rather than through strict enforcement.