A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique?

"Ask a family member to check the locks for you at night."

"Focus on abdominal breathing whenever you go to check the locks."

"Keep a journal of how often you check the locks each night."

"Snap a rubber band on your wrist when you think about checking the locks."

Answer and Explanation

The Correct Answer is D

A.   Having a family member check the locks may provide temporary relief but does not address the
client’s compulsive behaviors or promote self-control.
B.   Abdominal breathing may help with anxiety, but it does not directly address the obsessive thoughts related to checking the locks.
C.   Keeping a journal may help track the behavior, but it does not serve as an intervention for the compulsion itself.
D.   Thought-stopping involves using a physical cue, such as snapping a rubber band, to interrupt the cycle of obsessive thinking and help the client refocus.

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Correct Answer is D

Explanation

A. Isolation is more characteristic of depressive episodes rather than mania. In acute mania, clients tend to be overly social and energetic, not isolative.
B. While clients in mania may display excessive energy, writing a detailed daily schedule is not a typical symptom. Mania is more often associated with impulsiveness and a lack of focus.
C. Refusing to engage in conversation would suggest withdrawal, which is common in depressive states, not mania.
D. A lack of sleep is a hallmark symptom of acute mania, as individuals often feel energized and do not require the usual amount of rest, leading to sleep disturbances.

A. "I think you should ignore the comment." B. "You sound upset about today's session." C. "Why do you think that he said that to you?" D. "I agree that the comment was inappropriate."

Correct Answer is B

Explanation

A. Ignoring the comment may invalidate the client’s feelings and may not address any underlying issues. It’s essential to acknowledge the client’s emotions and explore the situation further.
B. This response acknowledges the client’s feelings and opens the door for further discussion. It helps the nurse understand the client’s emotional state and provides an opportunity for resolution.
C. This question may make the client feel defensive or pressured. It is better to first explore the client’s
emotional response before delving into the specifics of the other client's behavior.
D. Agreeing with the client may cause the nurse to become emotionally involved, which is not ideal. It’s better to remain neutral and focus on the client’s feelings and how they were impacted by the comment.

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A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique?

Nursing Test Bank

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