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?

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

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

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

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

Answer and Explanation

The Correct Answer is A

Choice A rationale:

"Snap a rubber band on your wrist when you think about checking the locks.”. This choice suggests using a painful stimulus (the rubber band snap) as part of the thought-stopping technique. While it may interrupt the client's behavior temporarily, it is not a recommended or ethical approach, as it can cause harm and distress to the client.

Choice B rationale:

"Keep a journal of how often you check the locks each night.”. Keeping a journal may be useful for tracking behavior patterns, but it doesn't address the core issue of obsessive-compulsive disorder. It is essential to provide the client with a more active technique for managing their compulsions, like the one mentioned in choice C.

Choice D rationale:

"Ask a family member to check the locks for you at night.”. This choice does not promote independence or self-management, which is an important goal in treating obsessive-compulsive disorder. It may alleviate the client's anxiety temporarily but does not help the client develop skills to manage their obsessive-compulsive tendencies on their own.

Choice C rationale:

"Focus on abdominal breathing whenever you go to check the locks.”. This response is the most appropriate because it recommends a self-soothing and grounding technique (abdominal breathing) to help the client manage their obsessive thoughts and compulsions. It encourages the client to be more mindful and reduce the urge to perform repetitive behaviors, which is a key aspect of treating obsessive-compulsive disorder. .

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Correct Answer is A

Explanation

Choice A rationale:

(Statement then rationale) Choice A is the correct option. A blood pH of 7.60 indicates severe metabolic alkalosis, which is a life-threatening condition. Metabolic alkalosis can lead to various complications, including cardiac arrhythmias, muscle weakness, and even seizures. Immediate intervention is required to address the underlying cause and correct the pH imbalance. The nurse should initiate treatments to restore the acid-base balance promptly.

Choice B rationale:

(Statement then rationale) Choice B is not the correct option. While a BUN level of 21 mg/dL is above the normal range, it alone does not require immediate intervention. Elevated BUN can be caused by various factors and may not be immediately life-threatening. It is important to assess the client's overall clinical condition and consider other lab values to make a comprehensive assessment.

Choice C rationale:

(Statement then rationale) Choice C is not the correct option. +2 edema of the lower extremities, while indicating fluid retention, is not an immediate life-threatening condition. Edema should be assessed and addressed, but it does not require emergency intervention as much as a severely altered blood pH does.

Choice D rationale:

(Statement then rationale) Choice D is also not the correct answer. Lanugo covering the body is a physical manifestation often seen in clients with anorexia nervosa and indicates malnutrition. While it is concerning and requires attention, it is not an acute, life-threatening issue. Nutritional rehabilitation and support are needed, but immediate intervention is necessary for the severe metabolic alkalosis indicated by a blood pH of 7.60. Now, let's proceed to the next question.

A. Report suspected abuse to Child Protective Services. B. Determine the immediate safety needs of the child. C. Request that the parent leave the room while interviewing the child. D. Ask the child how the injury occurred.

Correct Answer is B

Explanation

Choice A rationale:

Reporting suspected abuse to Child Protective Services is important when there are concerns of child abuse. However, in this scenario, the nurse's first priority should be to ensure the immediate safety and well-being of the child. Without assessing the child's safety, it would be premature to report abuse. Child Protective Services can be involved later if necessary.

Choice C rationale:

Requesting that the parent leave the room while interviewing the child can be a useful strategy when there are concerns about abuse or when the child needs to speak freely. However, this should not be the first action. Ensuring the child's immediate safety takes precedence.

Choice D rationale:

Asking the child how the injury occurred is important in gathering information, but it should not be the first action. Ensuring the child's safety is of primary importance, and this information can be gathered after immediate safety needs are addressed.

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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?

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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?