A nurse is caring for a client who has borderline personality disorder (BPD). As part of the client's plan of care, the nurse reviews the day's schedule with the client each morning. As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client?

A. Limit the amount of time available to interact with others. This statement does not align with the typical behavior of individuals with obsessive-compulsive disorder (OCD). While the client's behavior of constantly picking up after others may indirectly limit interaction time, the primary motivation behind this behavior is more likely related to managing anxiety rather than intentionally limiting social interaction.

B. Manipulate and control others' behaviors. While individuals with OCD may engage in behaviors that affect others, such as seeking reassurance or involving others in their rituals, the behavior described in the scenario does not appear to be aimed at manipulating or controlling others. Instead, it seems driven by the client's internal need to alleviate anxiety through compulsive actions.

C. Decrease anxiety to a tolerable level. This is the correct choice. People with OCD often engage in compulsive behaviors as a way to reduce distressing feelings of anxiety or discomfort. By picking up after others compulsively, the client may experience temporary relief from obsessive thoughts and the associated anxiety. However, the relief is typically short-lived and can lead to a cycle of compulsive behaviors.

D. Focus attention on meaningless tasks. While the behavior of constantly picking up after others may seem repetitive or meaningless to an observer, individuals with OCD typically attribute great significance to their compulsive actions. These behaviors are driven by the need to reduce anxiety or prevent perceived harm rather than a deliberate focus on meaningless tasks.

B. Ability to perform calculations: Assessing the client's ability to perform calculations helps in evaluating cognitive functioning. Impairments in calculation abilities can indicate cognitive decline associated with dementia. Tasks such as simple arithmetic or counting backward can be included in the assessment.

C. Long-term memory: Evaluating long-term memory is essential as it helps assess the client's ability to recall events, experiences, and information from the distant past. Long-term memory deficits are often seen in various types of dementia, and assessing this aspect provides valuable information about the extent of cognitive impairment.

D. Level of orientation: Assessing the client's level of orientation to time (e.g., awareness of date, day, season), place (e.g., awareness of current location), and person (e.g., awareness of self and others) is crucial in evaluating cognitive function. Orientation deficits are common in dementia and can provide insights into the progression and severity of the condition.

E. Recall ability: Evaluating the client's ability to recall recent events, information, or instructions assesses short-term memory function, which is often impaired in dementia. Tasks such as asking the client to repeat a series of words or recall recent activities help in assessing recall ability and memory impairment associated with dementia.