A client is being evaluated for potential OCD. The nurse explains the differential diagnosis process. Which observation supports the diagnosis of OCD rather than another mental disorder?

The client's obsessions and compulsions are consistent with their self-image.

The client engages in compulsions to achieve pleasurable outcomes.

The client's obsessions and compulsions are not causing significant distress.

The client recognizes that their obsessions and compulsions are irrational.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

The observation that the client's obsessions and compulsions are consistent with their self-image would not necessarily support the diagnosis of OCD. This could be applicable to other mental disorders as well, where the symptoms align with the individual's self-concept.

Choice B rationale:

If the client engages in compulsions to achieve pleasurable outcomes, this might suggest a different perspective. OCD compulsions are typically performed to alleviate distress or prevent a feared event, not for achieving pleasure.

Choice C rationale:

If the client's obsessions and compulsions are not causing significant distress, this could point towards other disorders or even potentially normal behavior. OCD is characterized by the distress caused by the obsessions and the urge to perform compulsions to alleviate this distress.

Choice D rationale:

The correct answer. In OCD, individuals are aware that their obsessions and compulsions are irrational and excessive. This self-awareness differentiates OCD from other disorders where the beliefs and behaviors might be seen as reasonable by the individual.

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Correct Answer is D

Explanation

Choice A rationale:

The statement "I always arrange my books on the shelf from tallest to shortest" doesn't indicate an obsession. This behavior might suggest a preference for orderliness or arranging things systematically, but it lacks the distressing, unwanted nature of obsessions.

Choice B rationale:

"I feel an overwhelming urge to wash my hands every 30 minutes" indicates a compulsion rather than an obsession. The urge to wash hands frequently is driven by the need to alleviate anxiety or distress, which is the hallmark of compulsive behaviors.

Choice C rationale:

"I have a ritual of counting to 10 before entering any room" is also a compulsion. The ritual of counting serves as a way to reduce anxiety or prevent a feared outcome associated with entering a room, suggesting a compulsive behavior.

Choice D rationale:

The statement "I keep having thoughts that my family will get hurt if I don't touch the doorknob three times" reflects an obsession. The distressing thought of family harm is the unwanted obsession, and the ritual of touching the doorknob three times is the compulsion aimed at reducing the anxiety caused by the obsession.

A. Encourage the client to talk about their fears. B. Set limits on the client's behavior. C. Assist the client in gradual exposure to feared situations. D. Provide the client with relaxation techniques.

Correct Answer is C

Explanation

Choice A rationale:

Encouraging the client to "talk about their fears" might be a beneficial intervention in some cases, but for individuals with OCD who are struggling with compulsive behaviors driven by their fears, directly addressing exposure to those fears is a more effective approach.

Choice B rationale:

While setting limits on the client's behavior is important, it may not be the priority in this situation. Instead, assisting the client in gradually confronting their fears through exposure therapy can help them develop healthier coping mechanisms.

Choice C rationale:

The correct response emphasizes gradual exposure therapy, a well-established approach in treating OCD. This intervention helps the client confront their fears in a controlled and systematic manner, leading to desensitization and reduction in their anxiety over time.

Choice D rationale:

Providing relaxation techniques can be helpful for managing anxiety, but for someone with OCD who is avoiding situations due to contamination fears, the primary intervention should focus on exposure therapy to address the specific OCD-related fears.

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A client is being evaluated for potential OCD. The nurse explains the differential diagnosis process. Which observation supports the diagnosis of OCD rather than another mental disorder?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD) Which statement by the client indicates an obsession?

Correct Answer is D

Explanation

A nurse is caring for a client with OCD who is refusing to leave their room because they are afraid of contamination. Which of the following interventions should the nurse prioritize?

Correct Answer is C

Explanation

A nurse is providing care for a client with obsessive-compulsive disorder (OCD) Which statement by the nurse would be most appropriate in this situation?

A nurse is caring for a client with OCD who is experiencing an anxiety attack. The client is saying, "I have to wash my hands! I have to wash my hands!" Which of the following responses should the nurse make?

A nurse is explaining the diagnostic criteria for obsessive-compulsive disorder (OCD) to a group of nursing students. Which of the following statements accurately reflects one of the criteria for diagnosing OCD?

A client with OCD is concerned about the potential side effects of medication. The nurse explains that the choice of medication depends on several factors. Which factor is likely to influence the choice of medication for treating OCD?

A nurse is providing care to a client with trichotillomania (hair-pulling disorder) What intervention would be most appropriate to include in the client's care plan?

A client with OCD is undergoing cognitive-behavioral therapy (CBT) The client asks the nurse, "How does exposure and response prevention work in treating OCD?" Which response by the nurse accurately explains this aspect of CBT?

A nurse is educating a group of patients with OCD about their condition. Which information should the nurse include in the education session?

A nurse is assisting a patient with OCD in developing a hierarchy of feared stimuli for exposure therapy. Which statement by the nurse is appropriate during this process?