A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values?

Choice A reason : Encouraging avoidance of anxiety-increasing situations may seem beneficial, but it can reinforce OCD behaviors. Avoidance prevents the client from learning how to cope with anxiety and can limit their ability to participate in daily activities⁴.

Choice B reason : Investigating what situations precipitate anxiety is a crucial step in managing OCD. Understanding the specific triggers can help in developing strategies to cope with and eventually reduce the anxiety associated with these situations. This approach is aligned with cognitive-behavioral therapy principles, which are effective in treating OCD⁴⁵.

Choice C reason : Teaching the client that compulsive behavior is excessive is part of psychoeducation. However, simply telling a client that their behavior is excessive without providing coping mechanisms can be unhelpful and may increase their anxiety. It's important to combine this with therapeutic techniques that help the client manage their compulsions⁴.

Choice D reason : Preventing the client from performing compulsive behavior abruptly can cause significant distress and may not be feasible or safe. Instead, treatment usually involves gradual exposure to anxiety-provoking situations and learning to resist the urge to perform compulsions, a technique known as exposure and response prevention (ERP)⁴.

Choice A reason : Conducting 15-minute checks can be part of the safety measures for a client at risk of self-harm, but it may not be sufficient for someone who is actively hearing voices commanding self-harm and refusing to engage in safety planning. These checks are less intensive and may not provide the immediate intervention needed to ensure the client's safety¹.

Choice B reason : Encouraging the client to express feelings related to suicide is an important therapeutic intervention that can provide insight into the client's emotional state and risk factors. However, if the client is actively psychotic and not engaging in safety planning, this approach alone may not be enough to ensure immediate safety¹.

Choice C reason : Placing the client on one-to-one observation is the most direct and immediate intervention to ensure safety when a client is experiencing psychotic features and is at risk of self-harm. This level of observation means that the client is never alone, and a staff member is always present to intervene if the client attempts self-harm¹.

Choice D reason : Obtaining an order for locked seclusion can be considered if other less restrictive measures are not sufficient to ensure the client's safety. However, it is generally a last resort due to the potential for negative psychological effects and should only be used when absolutely necessary and when other interventions have failed¹.