Which is the desired outcome for a client with obsessive-compulsive disorder (OCD)?

That the OCD symptoms no longer interfere with the client's responsibilities

To relieve the client with OCD of any responsibilities

That the client will no longer experience any signs or symptoms of OCD

That the client will no longer experience anxiety

Answer and Explanation

The Correct Answer is A

Obsessive-Compulsive Disorder (OCD) is characterized by obsessions (intrusive, persistent thoughts) and compulsions (repetitive behaviors performed to alleviate the anxiety caused by the obsessions). Because OCD is often a chronic condition, the goal of psychiatric nursing is not necessarily the total eradication of thoughts, but rather functional restoration and the reduction of the symptoms' power over the client’s life.

Rationale:

A. The most realistic and desired outcome is that the client can function effectively in their social and occupational roles. Success is measured by the client’s ability to manage their time and energy so that compulsions do not prevent them from fulfilling their daily responsibilities or maintaining relationships.

B. Relieving a client of all responsibilities is a counterproductive intervention. This approach encourages the sick role and can actually increase the time a client has available to engage in ritualistic behaviors, ultimately worsening the severity of the disorder and decreasing the client’s self-esteem.

C. While total symptom remission is an ideal, it is often unrealistic for many clients with OCD. Expecting a complete absence of symptoms can lead to frustration and a sense of failure if an intrusive thought occurs. The clinical focus is on management and control rather than a cure.

D. Anxiety is a universal human emotion and a core component of the OCD cycle. The goal is to help the client develop coping mechanisms to manage anxiety without resorting to rituals (such as through Exposure and Response Prevention), rather than the impossible goal of never experiencing anxiety again.

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Correct Answer is B

Explanation

The clinical presentation of "missing time," behavior that feels alien to the individual’s normal personality, and amnesia for specific events are hallmark indicators of a dissociative process. While the prompt asks about personality disorder, the symptoms described specifically align with dissociative identity disorder (DID), where the consciousness shifts between distinct personality states or alters.

Rationale:

A. Body dysmorphic disorder is characterized by an obsessive preoccupation with perceived flaws in physical appearance. It does not involve memory loss or distinct behavioral changes, but it manifests as repetitive behaviors like checking mirrors or seeking cosmetic procedures to fix a non-existent defect.

B. Dissociative identity disorder (formerly multiple personality disorder) involves a disruption of identity characterized by two or more distinct personality states. A key diagnostic criterion is recurrent gaps in the recall of everyday events or important personal information. The client’s strange behavior and lack of memory regarding their nighttime outings are classic examples of dissociative amnesia during an alter's transition.

C. Antisocial personality disorder is defined by a pattern of disregard for and violation of the rights of others. While these individuals may be deceitful, they do not experience amnesia for their actions. Their behaviors are intentional and driven by a lack of remorse, rather than a fragmented consciousness.

D. Borderline personality disorder involves intense emotional instability, impulsivity, and a fragmented self-image. Individuals with BPD may experience transient dissociation during periods of extreme stress, but they do not typically exhibit the organized, alternate personality behaviors and profound amnesia described in this scenario.

A. The survivor forgets about the loss. B. The survivor begins to reestablish a sense of personal identity, direction, and purpose for living. C. The survivor's life returns to the same state as it was before the loss. D. The survivor develops new ways of managing life and new relationships. E. The survivor begins to gain independence and confidence.

Correct Answer is ["B","D","E"]

Explanation

Bereavement involves the complex biopsychosocial process of responding to loss, necessitating the reorganization of the survivor's internal and external worlds. The emotional dimension of grieving requires affective processing to achieve the integration of the loss into the individual's new reality. Successful resolution is marked by the ability to experience psychological homeostasis and find meaning while moving forward without the physical presence of the deceased.

Rationale:

A. Forgetting about the loss is not a healthy or expected outcome of grief resolution. Healthy grieving involves maintaining a continuing bond with the deceased while acknowledging the reality of the death. Attempting to forget suggests the use of maladaptive defense mechanisms, such as repression, rather than the successful integration of the experience.

B. Reestablishing identity and purpose indicates the survivor is successfully navigating the reconstruction phase. Grief often shatters a person's sense of self, especially if their identity was closely tied to the deceased. Developing a new sense of agency and direction is a vital sign of emotional healing and adaptation to the new life circumstances.

C. A survivor's life can never return to the exact same state as it was before the loss, as the death represents a permanent transition. The goal of grieving is not restoration of the past, but rather functional adaptation to a changed reality. Expecting a return to the status quo can lead to complicated grief and emotional stagnation.

D. Developing new ways of managing life and forming new relationships demonstrates behavioral flexibility. This indicates the survivor has reached a level of accommodation where they can invest emotional energy into new areas of life. It reflects a shift from being occupied with the loss to engaging in restorative activities and social connections.

E. Gaining independence and confidence signifies that the survivor is mastering the functional demands of their new environment. This often involves learning skills previously performed by the deceased, which fosters a sense of self-efficacy. Increased confidence is a strong indicator that the acute emotional distress of grief is diminishing and being replaced by resilience.

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Which is the desired outcome for a client with obsessive-compulsive disorder (OCD)?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The bereaved client has worked through many processes of grief with the nurse. Which are eventual outcomes of the emotional dimension of grieving? Select all that apply.

Correct Answer is ["B","D","E"]

Explanation

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