A client, who is newly admitted with Obsessive-Compulsive Disorder, washes their hands ritualistically before any activity. They arrive late to meals and does not have time to finish eating. The appropriate nursing action would be to:

interrupt the handwashing and insist the client come to meals with everyone else.

provide the client's meals later and after the other clients have eaten.

notify the client when it is 30 minutes before the meal so they can begin their handwashing.

allow the client to continue as is but provide them access to the kitchen.

Answer and Explanation

The Correct Answer is D

a. Interrupt the handwashing and insist the client come to meals with everyone else. Interrupting ritualistic behaviors abruptly can increase distress and is not recommended. It may also reinforce the belief that the ritual is necessary.
b. Provide the client's meals later and after the other clients have eaten. This is not appropriate as it accommodates the OCD behavior and disrupts the mealtime routine for other clients.
c. Notify the client when it is 30 minutes before the meal so they can begin their handwashing. This is not appropriate as it enables the ritualistic behavior and may lead to increased anxiety if the client feels rushed to complete their ritual.
d. Allow the client to continue as is but provide them access to the kitchen. This is correct because it respects the client's autonomy while also providing an opportunity for gradual exposure therapy, where the client can work with the nurse to gradually reduce the time spent on rituals.

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Correct Answer is A

Explanation

a. experience no loss of contact with reality. The key difference is reality testing. Clients with neurosis (anxiety disorders, OCD) generally maintain contact with reality, even though their thoughts or behaviours might be distressing. Clients with psychosis (schizophrenia) experience a break with reality, such as hallucinations or delusions.
b. Never have mood or personality changes. Not true. Mood and personality changes can occur in both neurosis and psychosis.
c. Have conflict but only use adaptive defence mechanisms to cope. Défense mechanisms are used by everyone to cope with anxiety, but in neurosis, they might be less healthy or maladaptive.
d. Are always aware that their behaviours are maladaptive. Not necessarily. Clients with neurosis might have limited insight into how their behaviours affect themselves or others.

A. avoidance. B. obsessive-compulsive disorder. C. a conversion disorder. D. a fracture.

Correct Answer is C

Explanation

a. Avoidance: Avoidance is a coping mechanism, not a symptom itself.
b. Obsessive-compulsive disorder (OCD): OCD involves intrusive thoughts and repetitive behaviours, not physical symptoms like limb weakness.
c. a conversion disorder: Conversion disorder is a psychological condition where emotional distress manifests as physical symptoms, like limb weakness, with no medical explanation.
d. A fracture: A fracture is a physical injury with a demonstrable cause, unlike the unexplained weakness in conversion disorder.

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A client, who is newly admitted with Obsessive-Compulsive Disorder, washes their hands ritualistically before any activity. They arrive late to meals and does not have time to finish eating. The appropriate nursing action would be to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse's approach to a client with neurotic vs. psychotic behavior is different mainly because clients with neurotic behavior.

Correct Answer is A

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Correct Answer is C

Explanation

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