A nurse notices that a client with paranoid schizophrenia stops in mid-sentence when talking and tilts his head to the side as if to listen. The most appropriate intervention by the nurse would be to:

Choice A Reason:

Draws attention and approval from significant others.

This statement is incorrect. Compulsive washing rituals in Obsessive-Compulsive Disorder (OCD) are not typically performed to draw attention or gain approval from others. Instead, these rituals are driven by an internal need to reduce anxiety and distress associated with obsessive thoughts. The primary function of these behaviors is to manage the individual’s own anxiety rather than to seek external validation.

Choice B Reason:

Provides temporary and partial relief from anxiety.

This is the correct response. Compulsive washing rituals in OCD are performed to alleviate the intense anxiety and distress caused by obsessive thoughts. Although the relief is temporary and partial, it reinforces the behavior, creating a cycle where the individual feels compelled to repeat the ritual to manage their anxiety. This temporary relief is a key characteristic of compulsive behaviors in OCD.

Choice C Reason:

Increases the inhibitory powers of their superego.

This statement is incorrect. The concept of the superego is related to Freud’s psychoanalytic theory, where it represents the internalized moral standards and ideals. Compulsive washing rituals in OCD are not performed to increase the inhibitory powers of the superego but rather to reduce anxiety and distress. The rituals are a response to obsessive thoughts rather than a means of enhancing moral inhibition.

Choice D Reason:

Blocks delusions and hallucinations from awareness.

This statement is incorrect. Delusions and hallucinations are more commonly associated with psychotic disorders, such as schizophrenia, rather than OCD. Compulsive washing rituals in OCD are not intended to block delusions or hallucinations but to manage anxiety related to obsessive thoughts. The focus of these rituals is on reducing distress rather than addressing psychotic symptoms.

Choice A Reason:

Manifestation of dyslexia.

Dyslexia is a learning disorder characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. It is not typically associated with the creation of new words or phrases, which is what the term ‘mazurka’ represents in this context. Therefore, the client’s use of ‘mazurka’ is not a manifestation of dyslexia.

Choice B Reason:

Example of loose associations.

Loose associations refer to a thought disorder where ideas are presented with little or no logical connection between them. While this is a common symptom in schizophrenia, it does not specifically involve the creation of new words. The term ‘mazurka’ in this context does not illustrate a lack of logical connection between ideas but rather the invention of a new term.

Choice C Reason:

Neologism.

Neologism refers to the creation of new words or phrases that are often only understood by the person who created them. This is a common symptom in schizophrenia, where individuals may invent words that have meaning only to them. The client’s use of ‘mazurka’ fits this definition, as it is a newly created word that likely holds specific meaning for the client.

Choice D Reason:

Flight of ideas.

Flight of ideas is a symptom characterized by rapid and continuous speech with abrupt changes from topic to topic, usually based on understandable associations, distracting stimuli, or plays on words. This symptom is more commonly associated with manic episodes rather than schizophrenia. The use of ‘mazurka’ does not indicate rapid topic changes but rather the creation of a new word.