A nurse is contributing to the plan of care for a client who has obsessive-compulsive disorder (OCD) regarding brushing his teeth. The client brushes his tongue several times a day and has developed several ulcerations. Which of the following interventions should the nurse identify as a priority?

Provide information on stress reduction methods.

Assist the client to identify triggers to obsessive behaviors.

Speak to the client in a calm and soothing manner.

Assist the client in identifying his anxiety level.

Answer and Explanation

The Correct Answer is B

Choice A reason: While providing information on stress reduction is helpful, it is not the immediate priority.

Choice B reason: Assisting the client to identify triggers is a priority as it directly addresses the cause of the OCD behaviors.

Choice C reason: Speaking to the client in a calm manner is supportive but does not address the underlying OCD behaviors.

Choice D reason: Identifying anxiety levels can be part of the intervention, but it is not as specific as identifying triggers for the OCD behaviors.

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Correct Answer is C

Explanation

Choice A reason: Vomiting can be a sign of a transfusion reaction, but it is not as specific as low back pain for an acute hemolytic reaction.

Choice B reason: Urticaria, or hives, may indicate an allergic reaction but is not specific to an acute hemolytic reaction.

Choice C reason: Low back pain is a classic symptom of an acute hemolytic reaction, which is a serious and potentially life-threatening condition that requires immediate attention.

Choice D reason: Pulmonary congestion may occur in various conditions and is not the most specific indicator of an acute hemolytic reaction.

A. Requires an excessive amount of advice before making decisions. B. Uses physical appearance to make others take notice of him. C. Preoccupied with maintaining order by following rigid rules. D. Believes his achievements are superior to others.

Correct Answer is C

Explanation

Choice A reason: While individuals with obsessive-compulsive personality disorder may seek advice, it is not typically to an excessive amount, and this does not capture the essence of the disorder.

Choice B reason: Using physical appearance to gain attention is not a characteristic of obsessive-compulsive personality disorder; it is more associated with histrionic personality disorder.

Choice C reason: Being preoccupied with order and following rigid rules is a core feature of obsessive-compulsive personality disorder, reflecting a need for control and perfectionism.

Choice D reason: Believing one's achievements are superior to others is indicative of narcissistic personality disorder, not obsessive-compulsive personality disorder.

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A nurse is contributing to the plan of care for a client who has obsessive-compulsive disorder (OCD) regarding brushing his teeth. The client brushes his tongue several times a day and has developed several ulcerations. Which of the following interventions should the nurse identify as a priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who is receiving a blood transfusion. The nurse should monitor for which of the following findings as an indication the client is having an acute hemolytic reaction?

Correct Answer is C

Explanation

A nurse is collecting data from a client who has obsessive-compulsive personality disorder. Which of the following findings should the nurse include?

Correct Answer is C

Explanation

Debridement is:

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