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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While exploring childhood experiences may provide insight into the origins of fear, this approach does not directly help the client build the confidence and skills needed to engage socially in the present. It may keep the focus on the past rather than promoting immediate coping strategies.
Choice B reason: Offering reassurance without addressing the underlying cognitive distortions minimizes the client’s distress and may come across as dismissive. This response fails to provide practical tools for overcoming fear of rejection.
Choice C reason: Encouraging participation in large social gatherings too quickly can overwhelm a client with avoidant traits. Such exposure without proper preparation and gradual buildup is more likely to increase anxiety and avoidance rather than reduce it.
Choice D reason: Supporting the client in recognizing and challenging self-defeating beliefs, while practicing gradual social exposure, is evidence-based and therapeutic. This method uses cognitive-behavioral strategies that are effective in reducing avoidance, building self-esteem, and encouraging healthier relationships.
Correct Answer is A
Explanation
Choice A reason: Redirecting the focus back to the patient in a therapeutic and nonjudgmental way ensures the conversation remains centered on the client’s needs. This maintains professional boundaries while being supportive.
Choice B reason: Stating that nurses direct interviews is authoritative and may come across as rigid. It does not encourage patient openness.
Choice C reason: Responding with a prohibition sounds harsh and judgmental. It could damage rapport and shut down communication.
Choice D reason: Asking "why" can make the patient feel defensive, which is not therapeutic. It shifts the focus to justification rather than reflection.
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