A nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD) Which statement by the client indicates an obsession?
"I always arrange my books on the shelf from tallest to shortest.”
"I feel an overwhelming urge to wash my hands every 30 minutes.”
"I have a ritual of counting to 10 before entering any room.”
"I keep having thoughts that my family will get hurt if I don't touch the doorknob three times.”
The Correct Answer is D
Choice A rationale:
The statement "I always arrange my books on the shelf from tallest to shortest" doesn't indicate an obsession. This behavior might suggest a preference for orderliness or arranging things systematically, but it lacks the distressing, unwanted nature of obsessions.
Choice B rationale:
"I feel an overwhelming urge to wash my hands every 30 minutes" indicates a compulsion rather than an obsession. The urge to wash hands frequently is driven by the need to alleviate anxiety or distress, which is the hallmark of compulsive behaviors.
Choice C rationale:
"I have a ritual of counting to 10 before entering any room" is also a compulsion. The ritual of counting serves as a way to reduce anxiety or prevent a feared outcome associated with entering a room, suggesting a compulsive behavior.
Choice D rationale:
The statement "I keep having thoughts that my family will get hurt if I don't touch the doorknob three times" reflects an obsession. The distressing thought of family harm is the unwanted obsession, and the ritual of touching the doorknob three times is the compulsion aimed at reducing the anxiety caused by the obsession.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Teaching the client about the history of OCD might provide insight into the disorder's background, but it is not the priority when the client is currently experiencing distress. Addressing the immediate distress takes precedence over historical information.
Choice B rationale:
This choice is correct because relaxation techniques can help alleviate the client's distress in the moment. These techniques, such as deep breathing, progressive muscle relaxation, or mindfulness exercises, can help the client manage their anxiety and reduce the impact of obsessive thoughts.
Choice C rationale:
While providing information about medication options is important, it might not be the initial intervention when the client is in a state of distress. Medication discussions are typically part of a comprehensive treatment plan and should be addressed after addressing the client's immediate distress.
Choice D rationale:
Initiating exposure therapy sessions might exacerbate the client's distress at this point. Exposure therapy involves deliberately confronting feared situations, and it's important to prepare the client for this type of intervention before initiating it. Starting with relaxation techniques is a more appropriate approach.
Correct Answer is D
Explanation
Choice D rationale:
The type and severity of OCD, along with the client's preferences and tolerance, are key factors that influence the choice of medication for treating OCD. OCD symptoms can vary widely between individuals, and different medications may be more effective for specific symptom profiles. Additionally, the severity of symptoms and potential side effects of medications should be carefully considered. Client preferences and tolerances play a crucial role in treatment adherence and success. Collaborative decision-making between the client and healthcare provider ensures that the chosen medication aligns with the individual's needs and goals.
Choice A rationale:
While enhancing positive emotional outcomes is a desired effect of treatment, it's not a direct factor that influences the choice of medication for treating OCD. The choice of medication is primarily based on its mechanism of action and its demonstrated efficacy in targeting OCD symptoms.
Choice B rationale:
Completely eliminating all obsessions and compulsions immediately is often not a realistic expectation for OCD treatment. Medications and psychotherapeutic approaches aim to reduce the severity and frequency of symptoms, improve overall functioning, and enhance quality of life.
Choice C rationale:
Ego-syntonic obsessions and compulsions are those that are consistent with the individual's sense of self and values, making them less distressing and more difficult to recognize as irrational. While addressing ego-syntonic symptoms is important, this factor alone does not dictate the choice of medication. The overall symptom profile and the medication's mechanism of action are more influential factors.
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