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?

Choice A rationale:

Impaired social interaction. This choice is not the most appropriate nursing diagnosis for a client with obsessive-compulsive disorder (OCD) experiencing recurrent thoughts about contamination. OCD primarily involves anxiety-driven behaviors and rituals rather than impaired social interaction.

Choice B rationale:

Anxiety. This is the correct answer. Given that the client is experiencing recurrent thoughts about contamination, the most appropriate nursing diagnosis is anxiety. OCD is characterized by intrusive thoughts and rituals driven by anxiety. Addressing the anxiety component is essential for effective treatment.

Choice C rationale:

Risk for self-harm. While individuals with severe OCD may experience distress, the given information does not indicate an immediate risk for self-harm. Anxiety is the more relevant issue in this scenario.

Choice D rationale:

Obsessive-compulsive disorder. This choice describes the client's condition rather than a nursing diagnosis. Nursing diagnoses are used to identify specific client problems that nurses can address through care and interventions.

Choice A rationale:

Obsessions and compulsions are aimed at reducing anxiety or distress. This statement accurately describes a characteristic of obsessive-compulsive disorder (OCD) Obsessions are intrusive and unwanted thoughts, images, or urges that cause significant distress, while compulsions are repetitive behaviors or mental acts aimed at reducing the distress caused by the obsessions. These behaviors are performed in response to the distress and are intended to alleviate it. For example, if someone has an obsession about contamination, their compulsion might involve excessive hand washing to alleviate the anxiety associated with the obsession.

Choice B rationale:

Obsessions and compulsions are consistent with the individual's self-image. This statement is not accurate in differentiating OCD from other mental disorders. Obsessions and compulsions in OCD often involve themes that are inconsistent with the individual's self-image and are not representative of their true desires or intentions. For instance, someone with OCD might have obsessions about harming others, even if they have no actual desire to do so. These obsessions are not aligned with their self-image.

Choice C rationale:

The individual recognizes that obsessions and compulsions are irrational. This statement accurately describes another characteristic of OCD. People with OCD typically recognize that their obsessions and compulsions are irrational and unreasonable, but they feel compelled to engage in these behaviors to alleviate anxiety. This recognition of the irrational nature of their thoughts and actions is a distinguishing feature of OCD, differentiating it from other disorders where the person might not have such insight into the irrationality of their behaviors.

Choice D rationale:

Obsessions and compulsions may lead to positive emotional outcomes. This statement is not accurate in the context of OCD. Obsessions and compulsions are not aimed at achieving positive emotional outcomes. Instead, they are performed to reduce distress or anxiety. The relief gained from engaging in compulsions is temporary and often followed by a cycle of escalating compulsions to achieve the same level of relief, which contributes to the perpetuation of the disorder.

Choice E rationale:

Obsessions and compulsions cause impairment in daily functioning. This statement accurately describes another characteristic of OCD. The obsessions and compulsions associated with OCD can be time-consuming and interfere significantly with a person's daily activities, relationships, and overall quality of life. These behaviors can lead to impaired occupational and social functioning, making this statement a distinguishing feature of OCD.