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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. The voices are telling me to harm myself: This statement indicates command hallucinations with a potential for harm. It suggests that the patient is receiving directives to harm themselves, which poses an immediate safety concern. Implementing safety measures, such as close monitoring, removal of harmful objects, and involving appropriate professionals, is essential to protect the patient from self-harm.

B. I hear voices: While hearing voices (auditory hallucinations) is a symptom that requires assessment and intervention, the nature of the voices is crucial in determining the level of risk. This statement, on its own, does not provide information about the content or potential harm associated with the voices.

C. I see birds flying in the room: This statement describes a visual hallucination, which, while potentially distressing, does not necessarily pose an immediate safety risk to the patient or others. Visual hallucinations may be less likely to necessitate immediate safety measures compared to command hallucinations.

D. The voices don't stop and continue all day: This statement suggests persistent auditory hallucinations, but without information about the content of the voices, it does not specifically indicate a risk of harm. While it may be distressing for the patient, the urgency for safety measures depends on the nature of the auditory content.

A. Using authoritative leadership to help clients learn to conform to societal norms B. Being firm, consistent, and empathetic, while addressing specific client behaviors C. Promoting client expression by implementing laissez-faire leadership D. Overlooking inappropriate behaviors to avoid promoting secondary gains

Correct Answer is B

Explanation

A. Using authoritative leadership to help clients learn to conform to societal norms: Authoritative leadership may be perceived as controlling and is unlikely to be effective with clients diagnosed with borderline personality disorder. It can lead to resistance and difficulties in building a therapeutic alliance.

B. Being firm, consistent, and empathetic, while addressing specific client behaviors: This approach is most appropriate. Clients with borderline personality disorder often benefit from clear and consistent boundaries, along with empathy from the nurse. Addressing specific behaviors helps establish a structured and safe therapeutic environment.

C. Promoting client expression by implementing laissez-faire leadership: Laissez-faire leadership, characterized by minimal interference or direction, is generally not suitable for clients with borderline personality disorder. They may struggle with emotional dysregulation and benefit from a more structured and supportive approach.

D. Overlooking inappropriate behaviors to avoid promoting secondary gains: Overlooking inappropriate behaviors may reinforce maladaptive patterns and hinder progress in therapy. It is essential to address and work through specific behaviors while maintaining empathy and consistency.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which hallucination necessitates the nurse to implement safety measures? The patient says.

Correct Answer is A

Explanation

Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder?

Correct Answer is B

Explanation

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A nurse is caring for a client who has a mental illness and is without housing. The nurse should identify that which of the following interprofessional team members can help the client find housing?

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A nurse is planning care for a client who has paranoid schizophrenia. Which of the following interventions should be included in the plan of care?

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A nurse is discussing bias issues in mental health with a newly licensed nurse. Which of the following statements should the nurse include in the discussion?

Which nursing diagnosis should be prioritized when providing care to a client diagnosed with paranoid personality disorder?

During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style?