A nurse is planning care for a client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse plan to take?
Encourage avoidance of situations that increase anxiety.
Investigate what situations precipitate anxiety.
Teach the client that compulsive behavior is excessive.
Prevent the client from performing compulsive behavior.
The Correct Answer is B
Choice A reason : Encouraging avoidance of anxiety-increasing situations may seem beneficial, but it can reinforce OCD behaviors. Avoidance prevents the client from learning how to cope with anxiety and can limit their ability to participate in daily activities⁴.
Choice B reason : Investigating what situations precipitate anxiety is a crucial step in managing OCD. Understanding the specific triggers can help in developing strategies to cope with and eventually reduce the anxiety associated with these situations. This approach is aligned with cognitive-behavioral therapy principles, which are effective in treating OCD⁴⁵.
Choice C reason : Teaching the client that compulsive behavior is excessive is part of psychoeducation. However, simply telling a client that their behavior is excessive without providing coping mechanisms can be unhelpful and may increase their anxiety. It's important to combine this with therapeutic techniques that help the client manage their compulsions⁴.
Choice D reason : Preventing the client from performing compulsive behavior abruptly can cause significant distress and may not be feasible or safe. Instead, treatment usually involves gradual exposure to anxiety-provoking situations and learning to resist the urge to perform compulsions, a technique known as exposure and response prevention (ERP)⁴.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason : Fibromyalgia can indeed be associated with migraine headaches. Many individuals with fibromyalgia report experiencing headaches, and migraines are a common comorbidity. The exact link between fibromyalgia and migraines is not fully understood, but it is believed that the same abnormalities in neurotransmitter levels that contribute to fibromyalgia pain may also predispose individuals to migraines¹².
Choice B reason : The statement "Fibromyalgia causes joint inflammation" is incorrect and indicates a need for further teaching. Fibromyalgia does not cause inflammation within the joints. It is characterized by widespread musculoskeletal pain, fatigue, and tenderness in specific areas, but it does not involve the type of joint inflammation seen in conditions like rheumatoid arthritis¹². This misconception may arise because the symptoms can be similar to those of arthritic conditions, but the underlying mechanisms are different.
Choice C reason : Fibromyalgia may indeed cause chest pain, which is often referred to as costochondritis when it involves the cartilage of the rib cage. This chest pain can mimic that of a heart attack or other heart conditions, but it is actually a common symptom of fibromyalgia and is related to the tender points in the chest area¹².
Choice D reason : It is true that fibromyalgia symptoms may worsen depending on the weather. Many patients report that their symptoms flare up in response to changes in weather, temperature, and humidity. However, the reasons for this sensitivity are not entirely clear, and research on the subject has produced mixed results¹².
Correct Answer is B
Explanation
Choice A reason : Bradykinesia refers to the slowness of movement and is commonly associated with Parkinson's disease, not meningitis. It is characterized by a gradual loss of spontaneous movement and can affect the ability to initiate and continue movements¹.
Choice B reason : Brudzinski's sign is a clinical sign that suggests meningitis when neck flexion causes reflex flexion of the hips and knees. It occurs due to meningeal irritation caused by spinal cord movement or nerves against the meninges¹. This sign is considered positive when passive flexion of the neck results in reflex flexion of the hips and knees, indicating meningeal irritation².
Choice C reason : Kernig's sign is another clinical sign used to evaluate for meningitis. It involves extending and straightening one knee while the individual lies on their back with their hips and knees bent at a 90-degree angle. A positive Kernig’s sign indicates pain or resistance when the leg is extended, which suggests meningitis³. However, it is not the condition described in the scenario.
Choice D reason : Nuchal rigidity is an inability to flex the neck forward due to rigidity of the neck muscles. While it is a sign of meningitis, it does not involve the involuntary flexion of the legs as described in the scenario. Nuchal rigidity is typically assessed by attempting to flex the patient's neck forward while they are in a supine position⁴.
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