A 35-year-old client with OCD spends several hours each day arranging and rearranging household items in a specific order. The client becomes extremely distressed if the items are not arranged correctly. Which nursing intervention is most appropriate?

Assist the client in developing a structured schedule for activities of daily living

Provide education about the irrationality of the behavior

Collaborate with the client to set realistic goals for behavior change

Encourage the client to resist the urge to rearrange items

Answer and Explanation

The Correct Answer is C

A. A structured schedule may help with overall daily functioning, but it does not specifically address the compulsive behavior.

B. Educating the client about the irrationality of the behavior is unlikely to reduce the compulsions, as this is a hallmark of OCD, where the individual is often unable to control the urges despite understanding their irrationality.

C. Collaborating with the client to set realistic, gradual goals for changing the compulsive behavior is key in treating OCD. This approach allows the client to have input into their treatment plan and promotes realistic, achievable progress.

D. Encouraging the client to resist the urge to rearrange items without providing a structured approach may lead to increased anxiety and frustration. Gradual exposure and behavior modification are more effective.

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Correct Answer is A

Explanation

A. Valproate is associated with potential liver toxicity, so liver function tests must be monitored regularly during treatment.

B. Thyroid function tests are not required with valproate therapy, although they are important for other medications, such as lithium.

C. A pretreatment EEG is not necessary for valproate use. This test is typically used for clients with seizure disorders.

D. High serum sodium levels are not related to valproate toxicity; however, low sodium levels can increase the risk of toxicity.

A. Walking with the nurse in the courtyard B. Watching a video with a group in the day room C. Participating in a basketball game in the gym D. Joining a group discussion about a local election.

Correct Answer is A

Explanation

A. Walking with the nurse in the courtyard provides a simple, safe, and structured activity that promotes physical exercise and reduces excess energy in a way that is appropriate for someone in a manic state. This also gives the nurse an opportunity to observe the client's behavior and provide supervision.

B. Watching a video with a group might not engage the client sufficiently and could be too passive for someone experiencing mania who might need a more stimulating activity.

C. Participating in a basketball game could be too physically demanding and might escalate the client's manic behavior, especially if they have high energy or impulsivity.

D. Joining a group discussion about a local election may not be stimulating enough for the client in a manic state, as it requires focus and attention that might be difficult for the client to maintain during acute mania.

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A 35-year-old client with OCD spends several hours each day arranging and rearranging household items in a specific order. The client becomes extremely distressed if the items are not arranged correctly. Which nursing intervention is most appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

Correct Answer is A

Explanation

A nurse is caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored. Which of the following activities is appropriate for the nurse to suggest to this client?

Correct Answer is A

Explanation

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