An adult client is admitted to the psychiatric unit due to a daily, intricate handwashing ritual that lasts two hours or more.

The client is concerned about maintaining cleanliness and refuses to sit on any chairs in the day area.

This client’s handwashing is indicative of what type of clinical behavior?

Addiction

Compulsion

Obsession

Phobia

Answer and Explanation

The Correct Answer is B

Choice A rationale
Addiction refers to a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The intricate handwashing ritual that lasts two hours or more described by the client does not indicate substance use or dependency, which are common characteristics of addiction.
Choice B rationale

Compulsion refers to repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. The client’s intricate handwashing ritual that lasts two hours or more and their concern about maintaining cleanliness align with the definition of a compulsion.
Choice C rationale
Obsession refers to recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and unwanted. While the client’s concern about maintaining cleanliness could potentially be seen as an obsession, the act of handwashing is a behavior, which aligns more with the definition of a compulsion.
Choice D rationale
Phobia refers to an extreme or irrational fear of or aversion to something. The client’s behavior does not indicate an extreme or irrational fear but rather a compulsion to maintain cleanliness through an intricate handwashing ritual.

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Correct Answer is C

Explanation

Choice A rationale
Replacing the IV site with a smaller gauge is not the most appropriate intervention in this situation. The client’s confusion and picking at the dressing and tape are likely due to the dementia and increased confusion at night, known as “sundowning”. While a smaller gauge might be less noticeable to the client, it does not address the primary issue of the client’s confusion and restlessness at night.

Choice B rationale
Applying soft bilateral wrist restraints might be considered in some situations to prevent a confused client from removing necessary medical devices. However, restraints should be a last resort after all other interventions have been tried because they can increase agitation and confusion, and they pose a risk for injury.
Choice C rationale
Redressing the abdominal incision is the correct choice. The dressing is no longer occlusive, which means it’s not providing a proper barrier to bacteria. This could lead to an infection in the surgical site. The nurse should clean the area and apply a new sterile dressing.
Additionally, the nurse should continue to monitor the client’s behavior and implement interventions to reduce confusion and restlessness, such as reorienting the client and providing a quiet and calm environment.
Choice D rationale
Leaving the lights on in the room at night can actually increase confusion and agitation in clients with dementia. It can disrupt the client’s sleep-wake cycle and make “sundowning” worse. Therefore, this is not the most appropriate intervention.

A. Perform a thorough physical assessment B. Develop a safety plan C. Take photographs to document the abuse or neglect D. Confront the abuser about concerning actions E. he client in front of the suspected abuser F. Complete a comprehensive history G. Throw away soiled clothing

Correct Answer is ["A","B","C","F"]

Explanation

Choice A rationale
Performing a thorough physical assessment is crucial when elder mistreatment is suspected. It helps to identify any signs of physical abuse or neglect.
Choice B rationale
Developing a safety plan is an important step in ensuring the safety of the elder. This plan can include strategies to avoid potential harm and steps to take if the elder feels unsafe.
Choice C rationale

Taking photographs to document the abuse or neglect can provide concrete evidence of the mistreatment. These photographs can be used in investigations and legal proceedings.
Choice F rationale
Completing a comprehensive history is necessary to understand the full context of the elder’s situation. This includes the elder’s health status, living conditions, and the nature of their relationship with the caregiver.
Choice H rationale
Reporting findings to Adult Protective Services is a critical step in addressing elder mistreatment. Adult Protective Services can conduct further investigations and take necessary actions to protect the elder.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

What intervention(s) should the nurse initiate if elder mistreatment is suspected? Select all that apply.

Correct Answer is ["A","B","C","F"]

Explanation

What action should the school nurse take to provide secondary prevention for school-aged children?

A client with schizophrenia is admitted to the hospital reporting auditory hallucinations. Which query is most important for the nurse to include in the client’s assessment?

While conducting an admission assessment of a female client with bipolar disorder, the client suddenly starts to undress and throw her clothes around the room. What should be the nurse’s initial action?