Chapter 15

What kind of behavior does the nurse anticipate observing when treating a client obsessed with blasphemous thoughts?

  Praying repeatedly.

The nurse is providing education to a client prescribed clomipramine to help with obsessive-compulsive disorder. Which
statement by the client indicates the teaching was effective?

  "I may have a risk of suicidal thoughts with the medication."

The client has begun to wash the hands every hour due to the fear of germs becoming embedded in the client's skin
leading the client to develop cancer. The nurse interprets this behavior as indicating which condition?

  A compulsion

The nurse is caring for a client with dermatillomania. What symptoms of this disorder does the nurse recognize in this
client?

  Excoriation of the skin

How does the nurse help to decrease anxiety and build confidence in a client with obsessive-compulsive disorder?

  Help the client find alternative methods to deal with anxiety.

The nurse is assessing a client who spends several hours arranging and rearranging items around the house. What does
the nurse anticipate is the cause of this compulsive behavior?

  The client is preoccupied with perfection.

Which client is most likely to be diagnosed with body dysmorphic disorder (BDD)?

  A client who firmly believes that everyone who sees the client fixates on the size of the client's ears

Upon assessment, a client with a history of obsessive-compulsive disorder is terrified of losing control and has weight
overvaluation. For what comorbidity should the nurse assess in the client?

  eating disorder

The psychiatric mental health is reviewing the health record of a client who will soon be admitted. The client's health
history includes a diagnosis of body dysmorphic disorder. The nurse should anticipate that this client:

  is fixated on a specific physical flaw.

What interventions does the nurse use to promote therapeutic communication with the client diagnosed with obsessive-
compulsive disorder (OCD)?

  Explore the thoughts and feelings that trouble the client.

The nurse is assessing a client who performs ritualistic counting of objects in the client's surroundings. What does the
nurse tell the client about obsessive-compulsive disorder and its treatment? Select all that apply.

 Talk openly with the nurse about obsessions, compulsions, and anxiety.
 o not skip medication; it is an important part of the treatment.
 Learn and practice deep breathing and guided imagery.
Parents visit the clinic with their teenager to discuss the teen’s skin picking. Many bleeding wounds and various stages of
scabs located up and down both of the teenager’s arms. The parents are very upset about this behavior and want it to
stop. Which would the health care provider document?

  Excoriation disorder

The nurse is educating the client’s family about compulsive behavior. The nurse is correct when making which statement?

  The behavior neutralizes anxiety caused by obsessive thoughts.

The mental health nurse explains that the difference between an obsession and a compulsion can correctly be identified
as what?

  A compulsion involves repeating a seemingly purposeful action.

Which statement made by the nurse to the family of a client diagnosed with obsessive-compulsive disorder (OCD)
demonstrates the best general understanding of the chronic nature of the disorder and its management?
   "It's important to know that the symptoms will intensify during periods of stress."

  Explanation:
A client performs ritualistic washing of the hands and dishes, along with rearranging the table before settling down to a
meal. What intervention does the nurse implement to help this client complete this daily routine? Select all that apply.

 Include the time taken for the ritual in the day’s timetable.
 Come to an agreement with the client on a time to stop the ritual.
  Encourage a gradual decrease in the time allotted for the ritual.

What kinds of thoughts does the nurse identify in a client with obsessive-compulsive disorder (OCD)? Select all that apply.
 Unwanted
 Intrusive
 Impulsive
A client checks and rechecks the lock on the door five times before leaving home. What statement by the client indicates
that this behavior is a result of obsessive-compulsive disorder (OCD)?

  "I check until my anxiety subsides."

The nurse is caring for clients with obsessive-compulsive disorder (OCD). Which progressive and debilitating disorder
is most commonly seen with a late onset?

  Hoarding

A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are
in order of color. What term is used to identify this behavior?

  Compulsion

The psychiatric mental health nurse has received a referral from a community health nurse regarding a client who appears
to have hoarding disorder. When planning this client's care, the nurse should prioritize what consideration?

  Promoting the client's safety in the home environment

The nurse provides care to a client who is diagnosed with body dysmorphic disorder (BDD). Which client statement
indicates a need for the nurse to include risk for suicide into the client’s plan of care?

 “I was diagnosed with substance use disorder last year and I still struggle with it.”
A client diagnosed with obsessive-compulsive disorder (OCD) is prescribed a noninvasive procedure that uses magnetic
fields to simulate brain cells. Which treatment will the nurse anticipate ordered for the client?

  transcranial magnetic stimulation (TMS)

A client is diagnosed with trichotillomania. What would the nurse expect to observe with the client?

  hair loss on the scalp, eyebrows and/or eyelashes

Parents visit the clinic with their teenager to discuss the teen’s skin picking. Many bleeding wounds and various stages of
scabs located up and down both of the teenager’s arms. The parents are very upset about this behavior and want it to
stop. Which would the health care provider document?

  Excoriation disorder
A nurse is planning care for a client who has been diagnosed with trichotillomania. Which outcome should the nurse
include in the client's plan of care?

  Client will demonstrate healthy coping strategies for dealing with stressors
The nurse is assessing a client who spends several hours arranging and rearranging items around the house. What does
the nurse anticipate is the cause of this compulsive behavior?

  The client is preoccupied with perfection.

A nurse is conducting a strengths assessment on an adult client diagnosed with obsessive-compulsive disorder. What
question made by the nurse would help to identify the client’s strengths?

  “What are some talents that you have?”

What does the nurse teach the client with obsessive-compulsive disorder about relaxation techniques?

  Relaxation techniques should be practiced whenever possible.

What relaxation technique does the nurse teach the client with obsessive-compulsive disorder (OCD)?

  Practicing deep breathing

A counselor is conducting a therapy session with a client who performs time-consuming compulsions. The client is
exposed to a situation or object that induces anxiety in the client and the client is asked to refrain from performing the
ritualized behavior. What therapy is the counselor utilizing with the client?

 Exposure and Response Prevention (ERP)

A client diagnosed with obsessive-compulsive disorder (OCD) comes to the clinic with a spouse. During the visit, the
spouse states, “It isn't normal to always be checking and rechecking to make sure that all of the appliances are turned off
before we go out. It's nerve-wracking. We can never get out of the house on time. Isn't checking once enough?" Which
explanation of this behavior would the nurse need to incorporate into the response?

 The client performs the ritual to relieve anxiety temporarily.

Parents visit the clinic with their teenager to discuss the teen’s skin picking. Many bleeding wounds and various stages of
scabs located up and down both of the teenager’s arms. The parents are very upset about this behavior and want it to
stop. Which would the health care provider document?

 Excoriation disorder
The nurse is admitting a client with obsessive-compulsive disorder whose compulsion is washing hands. What should the
nurse explain to the client?

 "Applying lotion will help keep your skin from breaking down."