Review Practice Exercise 3

Obsessive-Compulsive and Related Disorders > Mental Health

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Practice Exercise 3

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Total Questions : 5

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Question 1:

Interventions for a client with OCD would include: Select all that apply.

A. Encouraging the client to verbalize feelings B. Helping the client to avoid obsessive thinking C. Interrupting rituals with appropriate distractions D. Planning with the client to limit rituals E. Teaching relaxation exercises to the client F. Telling the client to tolerate any anxious feelings

Answer and Explanation

Choice A:

Encouraging emotional expression allows the client to process obsessive thoughts and associated distress, which can reduce internal pressure and aid in symptom control.

Choice B:

Avoiding obsessive thinking reinforces the obsession by increasing its salience, making it more persistent rather than diminishing it.

Choice C:

Abruptly interrupting rituals without preparation may escalate distress, potentially worsening anxiety and resistance to therapy.

Choice D:

Collaborative planning to limit rituals supports gradual exposure while respecting the client’s readiness, reducing resistance and promoting adherence to interventions.

Choice E:

Relaxation techniques lower physiological arousal, helping the client manage anxiety and resist compulsions during exposure and response prevention therapy.

Choice F:

Tolerating anxious feelings builds resilience, reinforcing that discomfort is temporary and manageable without engaging in compulsive behaviors.

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Question 2:

The client with OCD has counting and checking rituals that prolong attempts to perform activities of daily living and get ready for activities of the day. The nurse knows that interrupting the client’s ritual to assist in faster task completion will likely result in:

A. A burst of increased anxiety B. Gratitude for the nurse’s assistance C. Relief from stopping the ritual D. Symptoms of depression or suicidality

Answer and Explanation

Choice A:

Interrupting rituals prematurely can cause an acute spike in anxiety because the compulsive act is a coping mechanism to neutralize obsessive distress.

Choice B:

Gratitude is unlikely since interference may be perceived as intrusive, leading to resentment rather than appreciation during heightened anxiety.

Choice C:

Relief is improbable because stopping rituals before completion leaves obsessions unresolved, increasing tension rather than decreasing it.

Choice D:

Although depression can coexist with OCD, sudden ritual interruption does not directly cause suicidality; this risk requires broader assessment over time.

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Question 3:

Clients with OCD often have exposure/response prevention therapy. Which of the following statements by the client would indicate positive outcomes for this therapy?

A. I am able to avoid obsessive thinking B. I can tolerate the anxiety caused by obsessive thinking C. I no longer have any anxiety when I have obsessive thoughts D. I no longer feel a compulsion to perform rituals

Answer and Explanation

Choice A:

Avoidance of obsessive thoughts is unrealistic, as therapy focuses on acceptance and management rather than suppression of intrusive thoughts.

Choice B:

Successful therapy involves exposure to feared stimuli while resisting compulsions, leading to improved tolerance of the anxiety rather than complete elimination of anxiety.

Choice C:

Complete absence of anxiety is not the goal; some residual anxiety is expected even with significant improvement.

Choice D:

Immediate loss of compulsion is unlikely; reduction occurs gradually, and therapy targets the ability to resist rather than instantly remove urges.

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Question 4:

Which of the following would be an appropriate intervention for a client with OCD who has a ritual of excessive, constant cleaning?

A. A structured schedule of activities throughout the day B. Intense psychotherapy sessions daily C. Interruption of rituals with distracting activities D. Negative consequences for ritual performance

Answer and Explanation

Choice A:

A structured daily schedule provides predictability and reduces idle time that could trigger compulsive cleaning. It supports behavioral activation and helps redirect attention toward goal-oriented tasks, minimizing ritual reinforcement.

Choice B:

Daily intense psychotherapy may overwhelm the client and increase distress, especially without gradual exposure. OCD treatment requires paced interventions like ERP, not high-frequency sessions that risk emotional exhaustion.

Choice C:

Distraction alone is a compulsion substitute and reinforces avoidance. While it may reduce anxiety temporarily, it fails to address the underlying obsession and does not promote habituation or cognitive restructuring.

Choice D:

Imposing negative consequences fosters shame, which exacerbates OCD symptoms. Punitive approaches are contraindicated and may worsen compulsive behaviors by increasing anxiety and reinforcing the obsession-compulsion cycle.

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Question 5:

A client with OCD is admitted to the hospital due to ritualistic hand washing that occupies several hours each day. The skin on the client’s hands is red and cracked, with evidence of minor bleeding. The goal for this client is:

A. Decreasing the time spent washing hands B. Eliminating the hand washing rituals C. Providing milder soap for hand washing D. Providing good skin care

Answer and Explanation

Choice A:

Reducing the time spent on compulsive hand washing is a realistic and measurable goal that decreases impairment without overwhelming the client’s ability to cope.

Choice B:

Abrupt elimination of compulsions can cause significant anxiety spikes, risking noncompliance and worsening symptoms.

Choice C:

Switching to a milder soap addresses skin irritation but does not treat the underlying compulsion or improve time management.

Choice D:

Good skin care supports comfort and prevents infection but fails to address behavioral control over the excessive hand washing.

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Practice Exercise 3

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