A client with obsessive-compulsive disorder (OCD) has been cleaning a bathroom for most of the morning. When the roommate demands that the client leave the bathroom so that the roommate can shower, the client becomes angry and says, "You can’t make me leave, everything is still dirty." What is the best nursing action?

Engage other staff members to remove the client from the bathroom.

Give a reminder that the client has been cleaning the bathroom for 1.5 hours and it is time to take a break.

Tell the client that the bathroom is very clean and that this behavior is unreasonable.

Tell the roommate to use the shower in another location.

Answer and Explanation

The Correct Answer is B

Choice A reason: Forcibly removing the client escalates anxiety and can increase resistance. This action does not support therapeutic management of OCD.

Choice B reason: Providing a clear, respectful, and time-limited reminder supports structure and helps the client redirect behavior without confrontation. It balances therapeutic boundaries with empathy.

Choice C reason: Dismissing the client’s concern as unreasonable invalidates their experience, increasing defensiveness and mistrust. This does not support treatment goals.

Choice D reason: Avoiding the problem by redirecting the roommate fails to address the client’s compulsive behavior and disrupts the care environment.

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Correct Answer is C

Explanation

Choice A reason: When anxiety is severe, the client cannot focus or process complex discussions. Asking them to explore worries may overwhelm them further.

Choice B reason: Providing extensive information is inappropriate in crisis moments because the client’s concentration and comprehension are impaired.

Choice C reason: Clear, calm, and brief communication helps reduce overstimulation, provides structure, and reassures the client during high anxiety. This is the most therapeutic choice.

Choice D reason: Rapid statements can escalate the client’s sense of being overwhelmed, increasing anxiety rather than calming it.

A. Preschoolers. B. Older adults. C. Young adults.

Correct Answer is C

Explanation

Choice A reason: Schizophrenia rarely presents in early childhood; cases in preschoolers are extremely uncommon and considered childhood-onset schizophrenia.

Choice B reason: While symptoms may persist into later life, new-onset schizophrenia is unusual in older adults and should prompt investigation for other causes such as dementia or medical illness.

Choice C reason: Schizophrenia most commonly develops in late adolescence to early adulthood, with men typically diagnosed in their late teens to early 20s and women in their late 20s to early 30s.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is exhibiting signs of severe anxiety, including hyperventilation, restlessness, and difficulty concentrating. Which communication approach should the nurse use to effectively support the client during this crisis?

Correct Answer is C

Explanation

A nurse is providing education to a group of staff members about schizophrenia. Which of the following age groups should the nurse include as the age when schizophrenia is typically diagnosed?

Correct Answer is C

Explanation

A client recently diagnosed with cancer continues to miss follow-up appointments and states, "The doctors must have made a mistake—there’s no way I’m that sick." According to Freud’s psychoanalytic theory, which defense mechanism is the client most likely using?

A recently widowed client becomes tearful at a routine clinic visit and states, "I just can’t get over my spouse’s death." Which of the following by the nurse are appropriate? (Select all that apply.)

The nurse plans care for a client newly admitted with obsessive-compulsive disorder who is repeatedly counting magazines in the commons room. Which of the following should the nurse include in the initial plan of care? (Select all that apply.)

A nurse practicing Peplau’s Relations Theory is working with a newly admitted client who is withdrawn and reluctant to engage. According to Peplau’s working model, which nurse action best explains the orientation phase of the nurse-client relationship?

The nurse on the mental health unit receives report about a client diagnosed with schizophrenia who has a delusion of reference. Which client statement supports this symptom?

A 28-year-old client with a diagnosis of Avoidant Personality Disorder tells the nurse, "I want to make friends. I'm too afraid they'll laugh at me or think I'm weak." Which nursing intervention is most appropriate to help this client begin developing healthier interpersonal relationships?

A nurse observes a hospitalized client grabbing snacks from other patients' trays, despite being told not to. When confronted, the client says, "I was hungry, so I took it." Based on Freud's psychoanalytic theory, which part of the personality is most likely influencing the client's behavior?