A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization?
The client will substitute a productive activity for mats by day one
The client will refrain from ritualistic behaviors during daylight hours.
The client will participate in the unit activities by day three
The Client will wake early enough to complete rituals prior to breakfast
The Correct Answer is B
A. The client will substitute a productive activity for rituals by day one: This outcome may be challenging to achieve within the first day, and it is important to set realistic goals. Moreover, focusing on substituting a productive activity might not address the immediate need to reduce ritualistic behaviors.
B. The client will refrain from ritualistic behaviors during daylight hours: This is an appropriate initial outcome. It acknowledges the challenge of completely eliminating rituals but sets a realistic goal of refraining from these behaviors during daylight hours. This allows for gradual progress without setting unrealistic expectations.
C. The client will participate in unit activities by day three: While participation in unit activities is a positive goal, it may be too optimistic to expect this within the first three days, especially considering the severity of obsessive-compulsive disorder symptoms.
D. The client will wake early enough to complete rituals prior to breakfast: This goal does not promote a reduction in ritualistic behaviors; instead, it may reinforce and accommodate the rituals. The aim of treatment for obsessive-compulsive disorder is to reduce the impact of these rituals, not to support them.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "After I clean your wounds, I would like for you to journal how you were feeling before you cut yourself."
This response is the most therapeutic. It acknowledges the patient's self-harm behavior, addresses the immediate physical needs by offering to clean the wounds, and encourages the patient to reflect on their emotions through journaling. This approach promotes self-awareness and provides a constructive coping strategy.
B. "I’m so sorry you cut your arms. Let's discuss how you were feeling."
This response is empathetic and encourages communication about the patient's emotions. While it acknowledges the self-harm and invites discussion, it does not suggest a specific coping strategy like journaling. It is still a supportive and therapeutic approach.
C. "Wow. What happened to you?"
This response may come off as judgmental or dismissive. It does not acknowledge the patient's emotional state or offer immediate support for the physical wounds. The tone and wording may make the patient feel uncomfortable or judged.
D. "What did you use to cut yourself! I will need to search your room."
This response is not therapeutic and may be perceived as confrontational and invasive. It does not prioritize the patient's emotional well-being and may violate the patient's trust and privacy. Searching the room without consent is not a recommended approach.
Correct Answer is B
Explanation
A. Use touch to calm the client during periods of anxiety:
Individuals with paranoid schizophrenia may have heightened sensitivity to touch, and it can potentially exacerbate their anxiety or paranoia. This intervention may not be appropriate as it could escalate the client's distress.
B. Check the client's mouth after the client takes medication:
This is the best choice. People with paranoid schizophrenia may be prone to hoarding or pocketing medications. Checking the client's mouth ensures that the medication has been swallowed, promoting medication adherence and preventing potential harm.
C. Rotate the staff assignments for this client:
Consistency in caregivers is generally preferred for clients with schizophrenia to build trust and a therapeutic relationship. Constantly changing staff assignments can lead to increased anxiety and mistrust.
D. Assign an assistive personnel to feed the client at meal times:
While assistance with feeding may be needed, assigning an assistive personnel without direct supervision for a client with paranoid schizophrenia may not be the best approach. It's important to ensure the client's safety and monitor their behavior during meals.
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