A nurse is assessing a client with obsessive-compulsive disorder (OCD) The client reports that they have been having recurrent thoughts about contamination. Which of the following is the most appropriate nursing diagnosis for this client?

Choice A rationale:

Encouraging the client to challenge negative thoughts is an effective cognitive-behavioral approach. It helps the client reframe their thinking patterns and build healthier self-esteem.

Choice B rationale:

Providing a list of alternative compulsions supports the client in finding healthier ways to cope with their anxiety. This can lead to a sense of accomplishment and improved self-esteem.

Choice C rationale:

Suggesting complete avoidance of anxiety triggers might seem helpful, but in the context of OCD, avoidance can reinforce the obsessions and compulsions. Gradual exposure and response prevention are evidence-based strategies.

Choice D rationale:

Assigning more exposure therapy sessions should be based on the client's progress and therapist's assessment. Increasing sessions solely for the sake of it might not be effective and could lead to frustration.

Choice E rationale:

Acknowledging the client's efforts in therapy fosters a positive therapeutic relationship and boosts their self-esteem. Recognizing progress and hard work encourages continued engagement in treatment.

Choice A rationale:

Impaired social interaction. This choice is not the most appropriate nursing diagnosis for a client with obsessive-compulsive disorder (OCD) experiencing recurrent thoughts about contamination. OCD primarily involves anxiety-driven behaviors and rituals rather than impaired social interaction.

Choice B rationale:

Anxiety. This is the correct answer. Given that the client is experiencing recurrent thoughts about contamination, the most appropriate nursing diagnosis is anxiety. OCD is characterized by intrusive thoughts and rituals driven by anxiety. Addressing the anxiety component is essential for effective treatment.

Choice C rationale:

Risk for self-harm. While individuals with severe OCD may experience distress, the given information does not indicate an immediate risk for self-harm. Anxiety is the more relevant issue in this scenario.

Choice D rationale:

Obsessive-compulsive disorder. This choice describes the client's condition rather than a nursing diagnosis. Nursing diagnoses are used to identify specific client problems that nurses can address through care and interventions.