A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?

Plan the client's schedule to allow time for rituals.

Confront the client about the senseless nature of the repetitive behaviors.

isolate the client for a period of time.

Set strict limits on the behaviors so that the client can conform to the unit rules and schedules.

Answer and Explanation

The Correct Answer is A

A. Plan the client's schedule to allow time for rituals.

Explanation:

For individuals with obsessive-compulsive disorder (OCD), engaging in rituals or repetitive behaviors can be a way to manage anxiety. Allowing time for these rituals within the client's schedule, while gently working towards reducing their impact, is a part of a gradual therapeutic approach known as Exposure and Response Prevention (ERP). ERP aims to help the client gradually face their anxiety triggers while refraining from engaging in compulsions.

Why the other choices are incorrect:

B. Confront the client about the senseless nature of the repetitive behaviors.

Confrontation can increase the client's anxiety and resistance to treatment. Instead, the nurse should approach the client with understanding and gradually work on strategies to reduce the compulsive behaviors.

C. Isolate the client for a period of time.

Isolating the client is not a therapeutic approach for managing OCD. It can lead to increased distress and negatively impact their mental health. Inclusion and support are more effective strategies.

D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules.

Setting strict limits may escalate the client's anxiety and could be counterproductive. It's important to work collaboratively with the client and apply evidence-based approaches like ERP to manage their symptoms effectively.

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Correct Answer is A

Explanation

A. "Are you thinking of harming yourself?": Correct

This is the priority response because it directly addresses the client's statement about being better off gone, which raises concerns about potential suicidal thoughts. Asking this question allows the nurse to assess the client's risk of self-harm or suicide and take appropriate actions to ensure their safety.

B. "Do you really think your family would be better off without you?": Incorrect

While this response attempts to engage the client in a conversation, it doesn't directly address the immediate concern of suicidal thoughts. It's important to prioritize assessing the client's safety before exploring their feelings about their family's perspective.

C. "When did you first start feeling this way?": Incorrect

While understanding the client's history and the onset of their feelings is important, it's not the priority response in this situation. Assessing the client's risk of harm takes precedence over gathering historical information.

D. "Tell me what is happening right now.": Incorrect

This response doesn't directly address the client's statement about being better off gone and doesn't assess the immediate risk of self-harm or suicide. While understanding the client's current situation is valuable, safety concerns should be addressed first.

A. "Clients who are involuntarily admitted have the right to informed consent." B. "Clients should be given medications even if they refuse them." C. "The laws regarding restraints are different for clients who are admitted involuntarily." D. "Clients who are admitted involuntarily can be hospitalized for as long as the provider deems necessary."

Correct Answer is A

Explanation

A. Clients who are involuntarily admitted to a mental health unit retain their rights, including the right to informed consent. This means they must be informed about their treatment, including medications, procedures, and potential risks, and they have the right to accept or refuse treatment, unless a court order states otherwise.

B.Involuntary admission does not automatically mean forced treatment. Clients can refuse medications, unless they are deemed a danger to themselves or others, in which case a court order may be obtained to administer medication.

C.Restraint laws apply equally to all clients, regardless of admission status. Restraints must always be used as a last resort and require a provider’s order, regular assessments, and documentation.

D.Involuntary hospitalization has legal time limits, and court review is required for extended hospitalization. The length of stay varies based on state laws and judicial rulings.

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A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?

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