An adult client is admitted to the psychiatric unit due to a daily, intricate handwashing ritual that lasts two hours or more.
The client is concerned about maintaining cleanliness and refuses to sit on any chairs in the day area.
This client’s handwashing is indicative of what type of clinical behavior?
Addiction
Compulsion
Obsession
Phobia
The Correct Answer is B
Choice A rationale
Addiction refers to a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The intricate handwashing ritual that lasts two hours or more described by the client does not indicate substance use or dependency, which are common characteristics of addiction.
Choice B rationale
Compulsion refers to repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. The client’s intricate handwashing ritual that lasts two hours or more and their concern about maintaining cleanliness align with the definition of a compulsion.
Choice C rationale
Obsession refers to recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and unwanted. While the client’s concern about maintaining cleanliness could potentially be seen as an obsession, the act of handwashing is a behavior, which aligns more with the definition of a compulsion.
Choice D rationale
Phobia refers to an extreme or irrational fear of or aversion to something. The client’s behavior does not indicate an extreme or irrational fear but rather a compulsion to maintain cleanliness through an intricate handwashing ritual.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"C,B"},"C":{"answers":"B"}}
Explanation
Choice A rationale
Chronic alcoholism is often associated with both Vitamin B12 and Folic acid deficiency anemia. Alcohol interferes with the absorption of these vitamins in the gut, leading to their deficiency.
Choice B rationale
Malabsorption syndrome can lead to Iron deficiency anemia, Vitamin B12 deficiency anemia, and Folic acid deficiency anemia. In malabsorption syndrome, the small intestine can’t absorb enough of certain nutrients and fluids.
Choice C rationale
Dietary deficiency can result in Iron deficiency anemia, Vitamin B12 deficiency anemia, and Folic acid deficiency anemia. These types of anemia can occur when the body doesn’t have enough of the vitamins needed to produce enough healthy red blood cells.
Correct Answer is A
Explanation
Choice A rationale
The most crucial intervention for a nurse to include in the care plan of a client with a deep vein thrombosis (DVT) in the left leg who is on a heparin protocol is to monitor for bleeding side effects related to heparin therapy. Heparin is an anticoagulant medication that prevents the formation of blood clots. While it is an effective treatment for DVT, it can also increase the risk of bleeding. Therefore, it is essential for the nurse to closely monitor the client for any signs of bleeding, such as unusual bruising, blood in urine or stool, or bleeding gums.
Choice B rationale
While promoting movement can help prevent a pulmonary embolism (a potential complication of DVT), it is not the most crucial intervention when a client is on a heparin protocol. Excessive movement can potentially dislodge the clot, leading to a pulmonary embolism. Therefore, while movement is important, it should be done under the guidance of a healthcare professional.
Choice C rationale
Checking blood pressure and heart rate at least every 4 hours is a standard nursing intervention for many clients, not just those with DVT. While it is important to monitor these vital signs, it is not the most crucial intervention for a client with DVT on a heparin protocol.
Choice D rationale
Measuring the circumference of each calf can help assess for leg edema, which can be a sign of DVT. However, this is not the most crucial intervention for a client on a heparin protocol. The priority is to monitor for bleeding side effects related to the heparin therapy.
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