A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and finds that the client demonstrates constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following?
Decrease the time available for interaction with people
Prevent aggressive and impulsive behaviors
Decrease anxiety.
Manipulate others
The Correct Answer is C
Individuals with OCD often engage in compulsive behaviors, such as repetitive cleaning, as a way to alleviate or decrease anxiety associated with obsessive thoughts. In the context of OCD, obsessions are intrusive and distressing thoughts, images, or urges that cause significant anxiety, while compulsions are repetitive behaviors or mental acts performed in response to the obsessions.
A. Decrease the time available for interaction with people:
While individuals with OCD may isolate themselves due to their symptoms, the primary motivation for repetitive behaviors like cleaning is to manage anxiety, not necessarily to avoid interaction with others.
B. Prevent aggressive and impulsive behaviors:
OCD compulsions are not typically aimed at preventing aggressive or impulsive behaviors. They are driven by the need to reduce distress related to obsessive thoughts.
C. Decrease anxiety:
This is the correct answer. Compulsive behaviors in OCD are often ritualistic actions performed to reduce the anxiety associated with obsessive thoughts. Cleaning, in this case, is a way for the individual to feel a sense of control and alleviate anxiety.
D. Manipulate others
The primary motive behind OCD compulsions is to manage personal anxiety, not to manipulate others. Individuals with OCD often recognize that their compulsions are excessive or irrational, but they feel driven to perform them to alleviate anxiety.
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Related Questions
Correct Answer is B
Explanation
A. fluoxetine (Prozac):
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety disorders. While SSRIs can have side effects, significant alterations in cardiac or cerebral electrical conductivity and fluid/electrolyte imbalance are not typically associated with fluoxetine. The primary concerns with SSRIs are related to serotonin levels and can include gastrointestinal disturbances, insomnia, and sexual dysfunction.
B. Lithium (Lithobid):
This is the correct answer. Lithium is known to have potential side effects related to cardiac and cerebral function, as well as fluid and electrolyte balance. Monitoring blood levels of lithium is crucial to avoid toxicity, which can affect the cardiovascular and central nervous systems. Lithium toxicity can lead to symptoms such as tremors, confusion, ataxia, and, in severe cases, seizures.
C. venlafaxine (Effexor):
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat depression and anxiety disorders. While it can cause some cardiovascular effects, the concern for significant alterations in cardiac or cerebral electrical conductivity and fluid/electrolyte imbalance is generally lower compared to lithium. The primary side effects of venlafaxine are related to serotonin and norepinephrine levels and may include increased blood pressure and heart rate.
D. clozapine (Clozaril):
Clozapine is an atypical antipsychotic medication used to treat schizophrenia. While antipsychotics can have side effects related to metabolic changes, significant alterations in cardiac or electrolyte imbalances are not typically associated with clozapine as the primary concern. Regular monitoring for metabolic side effects, such as weight gain and changes in lipid and glucose levels, is important with antipsychotic medications.
Correct Answer is A
Explanation
A. Use clear, calm statements and a confident physical stance:
This is the most appropriate choice. Clear and calm communication, along with a confident physical stance, can help to de-escalate the situation. It demonstrates assertiveness and can potentially prevent further escalation of violence.
B. Provide objective evidence that violence is unwarranted:
While providing objective evidence may be helpful in some situations, individuals with paranoid personality disorder may not respond well to attempts to prove that their perceptions are unwarranted. It could potentially escalate the situation.
C. Empathize with the client's paranoid perceptions:
While empathy is important in communication, empathizing with paranoid perceptions in a way that validates or reinforces them may not be the best approach. It could inadvertently validate the client's distorted thoughts and potentially escalate the situation.
D. Initially restrain the client to maintain safety:
Physical restraint should be a last resort and used only when the safety of the client or others is at immediate risk. Initial restraint can escalate aggression and may not be the most appropriate intervention in the early stages of a violent episode.
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