The nurse receives shift report about a male client with obsessive-compulsive disorder. The nurse completes moming rounds and approaches the cent while he is repeatedly washing the top of the same table. Which intervention should the nurse implement?
Encourage the client to be calm and relax for a little while.
Teach the client thought stopping techniques and ways to refocus behaviors.
Assist the client to identify stimuli that precipitates the activity.
Allow time for the behavior and then redirect the client to other
The Correct Answer is D
A. Simply encouraging the client to be calm and relax may not be effective for someone with obsessive-compulsive disorder.
B.
Teaching techniques is more appropriate for structured therapy sessions rather than addressing compulsive behavior in the moment.
C. While identifying stimuli can be useful, it is not an immediate intervention.
D.
This approach respects the client’s need to complete the compulsion to reduce anxiety while gradually redirecting attention, minimizing distress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
A. Family health history: A comprehensive family health history is crucial as it can reveal a pattern of certain diseases within a family. The client's parents both had heart disease, and his father had diabetes, which significantly increases the client's risk for these conditions.
B. Homosexual Lifestyle: This is not a risk factor for heart disease. Sexual orientation does not inherently increase the risk of heart disease. The inclusion of this option reflects a common misconception and is not medically relevant.
C. History of hypertension: Even though the client's blood pressure is currently managed with atenolol, a history of hypertension is a significant risk factor for heart disease. It's important to explore the duration and control of hypertension over time.
D. Vegetarian diet: Generally, a vegetarian diet is associated with lower risk factors for heart disease, such as reduced blood pressure and lower cholesterol levels. However, it's important to ensure that the diet is well-balanced and includes all necessary nutrients.
E.While exercise is generally beneficial for heart health, it is possible to overdo it. However, the client's episode occurred during jogging, which is typically a moderate form of exercise. Unless the client is engaging in extreme levels of exercise, this is unlikely to be a significant risk factor.
Correct Answer is D
Explanation
A. Securing the chest tube to the stretcher is important, but not as critical as keeping the chest tube container below the site of insertion to prevent backflow of fluids.
B. Administering PRN pain medication is important for comfort but is not the priority during urgent transport.
C. Marking the amount of chest drainage is part of ongoing monitoring and does not take precedence over the correct positioning of the chest tube container.
D. Keeping the chest tube container below the site of insertion ensures proper drainage by gravity and prevents complications such as tension pneumothorax.
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