Review Practice Exercise 1

Obsessive-Compulsive and Related Disorders > Mental Health

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Practice Exercise 1

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Total Questions : 5

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Question 1:

Which nursing diagnosis reflects the intrapersonal theory of the etiology of obsessive-compulsive disorder?

A. Ineffective coping related to punitive superego B. Ineffective coping related to active avoidance C. Ineffective coping related to alteration in serotonin D. Ineffective coping related to classic conditioning

Answer and Explanation

Choice A:

A punitive superego reflects intrapsychic conflict where excessive guilt and moral rigidity drive compulsive behaviors. This aligns with intrapersonal theory, which centers on internal psychological structures and unconscious defense mechanisms.

Choice B:

Avoidance is a behavioral concept, not intrapersonal. It reflects external coping strategies rather than internal psychological conflict, making it inconsistent with intrapersonal theory.

Choice C:

Serotonin imbalance is a biological explanation. It involves neurochemical dysfunction rather than internal psychological dynamics, thus not fitting the intrapersonal framework.

Choice D:

Conditioning is a behavioral theory mechanism. It explains OCD through learned associations, not through unconscious intrapsychic processes, making it incompatible with intrapersonal theory.

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Question 2:

A nurse is admitting a client diagnosed with obsessive-compulsive disorder (OCD) who has ordering issues. Which intervention should the nurse delegate to ancillary staff?

A. Assisting the client to store personal belongings to minimize the client’s anxiety B. Asking the client to identify someone who can be notified regarding the client’s admission C. Providing the client with the general “unit rules” that the client will be expected to follow D. Encouraging the client to talk to someone if feeling anxious or excited

Answer and Explanation

Choice A:

Assisting with storing belongings is a task-oriented activity that can be delegated to ancillary staff, provided it’s done in a way that respects the client’s compulsive ordering needs. This intervention supports physiological comfort and reduces anxiety without requiring clinical judgment.

Choice B:

Admission notification involves gathering psychosocial history and identifying support systems, which requires clinical assessment and is outside the scope of ancillary staff.

Choice C:

Rules orientation involves therapeutic communication and behavioral expectations, which must be tailored to the client’s psychiatric condition and requires nursing judgment.

Choice D:

Encouragement to talk about anxiety is a psychosocial intervention requiring therapeutic communication skills and awareness of the client’s mental status, which ancillary staff are not trained to provide.

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Question 3:

Which approach should a nurse use when working with an individual diagnosed with obsessive-compulsive disorder?

A. A rigid autocratic manner B. Very direct and confrontational C. Calm and nonconfrontational D. Direct and hurried

Answer and Explanation

Choice A:

Autocratic behavior may provoke resistance and worsen anxiety, undermining therapeutic rapport and increasing compulsive responses.

Choice B:

Confrontational tactics can trigger defensive reactions and intensify obsessive-compulsive symptoms, making treatment less effective.

Choice C:

A calm and nonconfrontational approach fosters trust and reduces anxiety, allowing the nurse to support the client’s coping mechanisms without escalating compulsive behavior.

Choice D:

Hurried interactions disregard the client’s need for control and predictability, increasing distress and impairing communication.

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Question 4:

Which of the following statements are correct regarding obsessive-compulsive disorder (OCD)? Select all that apply.

A. Obsessions are repetitive thoughts, whereas compulsions are ritualistic behaviors B. OCD symptoms can start as early as 3 years of age C. OCD patients often have difficulty sleeping D. Schizophrenia often occurs comorbidly with OCD E. There is a tool (scale) to measure compulsive behaviors F. Patients diagnosed with OCD are at higher risk for suicide than patients with depression

Answer and Explanation

Choice A:

Obsessions are intrusive, unwanted thoughts, while compulsions are repetitive actions aimed at reducing the anxiety provoked by these thoughts.

Choice B:

While rare cases may occur in young children, onset before age 5 is extremely uncommon, with typical onset in late childhood or adolescence.

Choice C:

Sleep problems occur due to heightened arousal and mental preoccupation with intrusive thoughts, making it difficult for patients to fall or stay asleep.

Choice D:

Schizophrenia is not a common comorbidity; OCD is more often associated with anxiety or depression, not primary psychotic disorders.

Choice E:

Structured tools such as the Yale-Brown Obsessive Compulsive Scale are used to measure symptom severity and guide treatment decisions.

Choice F:

Suicide risk in OCD is elevated compared to the general population, but generally lower than in severe depression without comorbid conditions.

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Question 5:

Which of the following statements explains the etiology of obsessive-compulsive disorder (OCD) from a biological theory perspective?

A. Individuals diagnosed with OCD have weak and underdeveloped egos B. Obsessive and compulsive behaviors are a conditioned response to a traumatic event C. Regression to the pre-Oedipal anal sadistic phase produces the clinical symptoms of OCD D. Abnormalities in various regions of the brain have been implicated in the cause of OCD

Answer and Explanation

Choice A:

The term ego stems from psychodynamic theory, not biological models. It reflects personality structure rather than neurochemical or anatomical dysfunction, making it irrelevant to biological etiology.

Choice B:

A conditioned response aligns with behavioral theory, not biological. While trauma may exacerbate symptoms, it does not explain the neurobiological underpinnings of OCD.

Choice C:

The anal sadistic phase is a Freudian concept from psychosexual development theory. It lacks empirical support and does not reflect current biological understanding of OCD.

Choice D:

Structural and functional abnormalities in the orbitofrontal cortex, anterior cingulate cortex, and basal ganglia disrupt inhibitory control and decision-making, contributing to compulsive behaviors. Neuroimaging consistently shows hyperactivity in these regions, supporting a biological etiology.

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Practice Exercise 1

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