A nurse is teaching a group of nursing students about the pathophysiology of obsessive-compulsive disorders (OCDs) Which brain circuit is thought to be involved in OCDs, and what are its main components responsible for regulating cognitive processes?

Limbic circuit consisting of the hippocampus, amygdala, and hypothalamus.

Central executive circuit comprising the prefrontal cortex and temporal lobes.

Cortico-striato-thalamo-cortical (CSTC) circuit including the orbitofrontal cortex, anterior cingulate cortex, striatum, and thalamus.

Ventral tegmental circuit involving the substantia nigra and ventral tegmental area.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

The limbic circuit consisting of the hippocampus, amygdala, and hypothalamus is not the main brain circuit involved in obsessive-compulsive disorders (OCDs) The limbic circuit is more closely associated with emotions and memory, rather than the cognitive processes that drive OCD symptoms.

Choice B rationale:

The central executive circuit comprising the prefrontal cortex and temporal lobes is responsible for higher-level cognitive functions like decision-making and working memory. However, this circuit is not primarily implicated in the pathophysiology of OCD.

Choice C rationale:

The correct choice. The cortico-striato-thalamo-cortical (CSTC) circuit plays a central role in the development of OCD. This circuit involves several key components: Orbitofrontal cortex: Responsible for assessing potential risks and rewards, and for decision-making. Anterior cingulate cortex: Involved in error detection, emotional processing, and regulating cognitive flexibility. Striatum: Responsible for habit formation and reward-based learning. Thalamus: Acts as a relay station for information between various brain regions. This circuit's malfunction can lead to repetitive behaviors and intrusive thoughts characteristic of OCD.

Choice D rationale:

The ventral tegmental circuit involving the substantia nigra and ventral tegmental area is primarily associated with the brain's reward system and the regulation of mood and motivation. It is not a key player in OCD's pathophysiology.

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Correct Answer is B

Explanation

Choice A rationale:

Avoiding situations that cause anxiety is counterproductive in exposure therapy, which is a common treatment for OCD. Exposure therapy involves gradual and controlled exposure to feared stimuli to reduce anxiety. Avoidance reinforces the anxiety response and prevents habituation. Facing the situations that trigger anxiety is crucial for desensitization.

Choice B rationale:

This choice is correct because exposure therapy for OCD involves facing feared situations while refraining from engaging in compulsions. Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession or according to rigid rules. By gradually exposing the individual to these situations and preventing them from performing compulsions, the anxiety response diminishes over time.

Choice C rationale:

Telling the patient that their fears will go away on their own is inaccurate and dismissive of the distress that OCD can cause. OCD is a chronic condition that typically requires evidence-based interventions for symptom reduction. Ignoring the fears and hoping they will disappear without intervention is not a valid therapeutic approach.

Choice D rationale:

Focusing only on situations that are easy to tolerate would not be effective in exposure therapy. The essence of exposure therapy is to confront situations that provoke anxiety gradually, starting with less anxiety-provoking situations and progressing to more challenging ones. This process helps the individual build resilience against anxiety triggers.

A. "Exposure and response prevention involves avoiding the triggers that lead to obsessions and compulsions.” B. "During exposure and response prevention, you'll engage in the compulsive behaviors to reduce anxiety gradually.” C. "Exposure and response prevention helps you face the situations that trigger anxiety while preventing the compulsive behaviors.” D. "In exposure and response prevention, we eliminate all exposure to the situations that cause distress and anxiety.”

Correct Answer is C

Explanation

Choice A rationale:

"Exposure and response prevention involves avoiding the triggers that lead to obsessions and compulsions." This statement is incorrect. Exposure and response prevention (ERP) in cognitive-behavioral therapy (CBT) for OCD involves facing the situations or triggers that lead to anxiety and obsessions. Instead of avoiding these triggers, individuals purposefully confront them to gradually reduce their anxiety response and break the cycle of performing compulsions in response to obsessions.

Choice B rationale:

"During exposure and response prevention, you'll engage in the compulsive behaviors to reduce anxiety gradually." This statement is also incorrect. ERP focuses on gradually reducing and eventually eliminating compulsive behaviors, not engaging in them. The goal is to help individuals learn that their anxiety naturally decreases over time when they refrain from performing the compulsions, ultimately breaking the connection between obsessions and anxiety-driven behaviors.

Choice C rationale:

"Exposure and response prevention helps you face the situations that trigger anxiety while preventing the compulsive behaviors." This statement accurately explains how exposure and response prevention works in treating OCD. During ERP, individuals purposefully confront situations that trigger their obsessions while refraining from engaging in compulsive behaviors. By doing so, they learn that their anxiety decreases without the need for compulsions, helping to weaken the link between obsessions and anxiety.

Choice D rationale:

"In exposure and response prevention, we eliminate all exposure to the situations that cause distress and anxiety." This statement is incorrect. ERP involves controlled exposure to distressing situations or triggers, not complete avoidance. The goal is to help individuals build tolerance to the anxiety triggered by these situations while resisting the urge to perform compulsions.

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A nurse is teaching a group of nursing students about the pathophysiology of obsessive-compulsive disorders (OCDs) Which brain circuit is thought to be involved in OCDs, and what are its main components responsible for regulating cognitive processes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting a patient with OCD in developing a hierarchy of feared stimuli for exposure therapy. Which statement by the nurse is appropriate during this process?

Correct Answer is B

Explanation

A client with OCD is undergoing cognitive-behavioral therapy (CBT) The client asks the nurse, "How does exposure and response prevention work in treating OCD?" Which response by the nurse accurately explains this aspect of CBT?

Correct Answer is C

Explanation

A client with body dysmorphic disorder (BDD) is explaining their experiences to a nurse. Which statements by the client indicate symptoms of BDD? Select all that apply.

A nurse is providing care for a client with obsessive-compulsive disorder (OCD) Which statement by the nurse would be most appropriate in this situation?

(Select all that apply) A nurse is implementing interventions for a patient with OCD based on the Nursing Interventions Classification (NIC) Which interventions would the nurse include for this patient?

A client with OCD is telling the nurse about their symptoms. Which of the following statements is most likely made by the client?

A nurse is caring for a client with OCD who is experiencing an anxiety attack. The client is saying, "I have to wash my hands! I have to wash my hands!" Which of the following responses should the nurse make?

A nurse is teaching a group of patients about treatment approaches for OCDs. Which statement accurately explains the rationale behind gradually increasing the dosage of medication during treatment?

A nurse is providing care to a client with trichotillomania (hair-pulling disorder) What intervention would be most appropriate to include in the client's care plan?

(Select all that apply):. A nurse is caring for a client with an eating disorder. What responsibilities should the nurse collaborate on with the multidisciplinary team? (Choose three.)