A female client with obsessive-compulsive personality disorder is admitted to the hospital for a cardiac catheterization. The afternoon before the procedure, the client begins to keep detailed notes of the nursing care she is receiving, and reports her findings to the nurse at bedtime. What action should the nurse implement?

Explain to the client that her behavior invades the rights of the nursing staff.

Teach the client strategies to control her obsessive-compulsive behavior.

Ask the client to explain why she is keeping a detailed record of her nursing care.

Encourage the client to express her feelings regarding the upcoming procedure.

None

Answer and Explanation

The Correct Answer is D

A. Explain to the client that her behavior invades the rights of the nursing staff: This approach is confrontational and dismisses the client’s coping mechanism. It does not promote a therapeutic nurse-client relationship.

B. Teach the client strategies to control her obsessive-compulsive behavior: This is not the appropriate time for teaching behavioral strategies, especially when the client is experiencing stress related to an upcoming invasive procedure.

C. Ask the client to explain why she is keeping a detailed record of her nursing care: While this might offer insight, it can come across as intrusive or judgmental. It also shifts the focus away from emotional support.

D. Encourage the client to express her feelings regarding the upcoming procedure: Clients with obsessive-compulsive personality disorder often rely on control and orderliness to manage anxiety. The nurse should recognize that the client’s behavior may be a coping mechanism for procedure-related stress. Encouraging expression of feelings promotes trust and addresses the underlying anxiety.

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Correct Answer is B

Explanation

A. Instructing the client to reduce the volume of his voice may not be effective during a manic episode and could escalate the situation.
B. Accompanying the client to a quiet area of the unit provides a more supportive and calming environment, allowing the client to deescalate.
C. Encouraging the client to attend a support group is a positive intervention but may not be immediately effective during an agitated state.
D. Administering a PRN sedative by injection may be considered, but less restrictive interventions should be attempted first to promote a therapeutic environment.

A. Participates in individual and group therapy. B. Demonstrates effective ways to cope with anxiety. C. Takes all antianxiety medications as prescribed. D. Learns methods of relaxation to reduce anxiety.

Correct Answer is B

Explanation

A. Participating in individual and group therapy is important for overall mental health, but the immediate focus is on addressing the self-harming behavior.
B. Demonstrating effective ways to cope with anxiety is the most important outcome to address the client's self-harming behavior and promote healthier coping mechanisms.
C. Taking all antianxiety medications as prescribed is important but may not directly address the client's self-harming behavior.
D. Learning methods of relaxation is valuable, but the most immediate concern is preventing self-harm. The client should demonstrate effective ways to cope with anxiety to reduce the risk of self-injury.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After meeting with a healthcare provider, a client who is diagnosed with bipolar disorder is screaming and stomping both feet while pacing the hallway. Which action should the nurse take?

Correct Answer is B

Explanation

The nurse develops a plan of care for a female client who scratches her wrists in attempts to deal with anxiety. Which client outcome is most important to include in the plan of care?

Correct Answer is B

Explanation

The nurse is leading a group on the inpatient psychiatric unit. Which approach should the nurse use during the working phase of group development?

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