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Module 31: Exemplar C - Obsessive-Compulsive Disorder

Terms in this set (15)

Answer: B, C, D
Explanation:

A) Obsessive-compulsive disorder affects men and women equally; however, women often develop the disorder in adolescence or early adulthood. Checking and repeating are two common compulsions related to symmetry obsessions. Lack of eye contact and using the bathroom during an assessment are not manifestations of the disorder.

B) Obsessive-compulsive disorder affects men and women equally; however, women often develop the disorder in adolescence or early adulthood. Checking and repeating are two common compulsions related to symmetry obsessions. Lack of eye contact and using the bathroom during an assessment are not manifestations of the disorder.

C) Obsessive-compulsive disorder affects men and women equally; however, women often develop the disorder in adolescence or early adulthood. Checking and repeating are two common compulsions related to symmetry obsessions. Lack of eye contact and using the bathroom during an assessment are not manifestations of the disorder.

D) Obsessive-compulsive disorder affects men and women equally; however, women often develop the disorder in adolescence or early adulthood. Checking and repeating are two common compulsions related to symmetry obsessions. Lack of eye contact and using the bathroom during an assessment are not manifestations of the disorder.

E) Obsessive-compulsive disorder affects men and women equally; however, women often develop the disorder in adolescence or early adulthood. Checking and repeating are two common compulsions related to symmetry obsessions. Lack of eye contact and using the bathroom during an assessment are not manifestations of the disorder.

Page Ref: 2095-2096
Cognitive Level: Analyzing
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing Process: Assessment
Learning Outcome: 31.C.4. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Identify the clinical manifestations of OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: B, E
Explanation:

A) Risk factors for obsessive-compulsive disorder include having a first-degree relative with the disorder and going through a major life stressor. Men develop the disorder earlier than women. Living with parents, being unemployed, or having a history of chronic illnesses are not risk factors for the disorder.

B) Risk factors for obsessive-compulsive disorder include having a first-degree relative with the disorder and going through a major life stressor. Men develop the disorder earlier than women. Living with parents, being unemployed, or having a history of chronic illnesses are not risk factors for the disorder.

C) Risk factors for obsessive-compulsive disorder include having a first-degree relative with the disorder and going through a major life stressor. Men develop the disorder earlier than women. Living with parents, being unemployed, or having a history of chronic illnesses are not risk factors for the disorder.

D) Risk factors for obsessive-compulsive disorder include having a first-degree relative with the disorder and going through a major life stressor. Men develop the disorder earlier than women. Living with parents, being unemployed, or having a history of chronic illnesses are not risk factors for the disorder.

E) Risk factors for obsessive-compulsive disorder include having a first-degree relative with the disorder and going through a major life stressor. Men develop the disorder earlier than women. Living with parents, being unemployed, or having a history of chronic illnesses are not risk factors for the disorder.

Page Ref: 2096
Cognitive Level: Analyzing
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing Process: Assessment
Learning Outcome: 31.C.3. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Outline the risk factors for OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: A
Explanation:

A) Do not interrupt the ritual because the client may feel compelled to start from the beginning. For the newly diagnosed client, teaching ritual interruption skills and teaching about antianxiety foods would not be the priority.

B) Do not interrupt the ritual because the client may feel compelled to start from the beginning. For the newly diagnosed client, teaching ritual interruption skills and teaching about antianxiety foods would not be the priority.

C) Do not interrupt the ritual because the client may feel compelled to start from the beginning. For the newly diagnosed client, teaching ritual interruption skills and teaching about antianxiety foods would not be the priority.

D) Do not interrupt the ritual because the client may feel compelled to start from the beginning. For the newly diagnosed client, teaching ritual interruption skills and teaching about antianxiety foods would not be the priority.

Page Ref: 2099
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing Process: Implementation
Learning Outcome: 31.C.7. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Apply the nursing process in providing culturally competent care to an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: D
Explanation:

A) Obsessive-compulsive disorder impacts the family system, especially with impaired role function. How frequently or thoroughly the client cleans the house may be important to assess, but they are not the most important. Forgetfulness is not a component of obsessive-compulsive disorder.

B) Obsessive-compulsive disorder impacts the family system, especially with impaired role function. How frequently or thoroughly the client cleans the house may be important to assess, but they are not the most important. Forgetfulness is not a component of obsessive-compulsive disorder.

C) Obsessive-compulsive disorder impacts the family system, especially with impaired role function. How frequently or thoroughly the client cleans the house may be important to assess, but they are not the most important. Forgetfulness is not a component of obsessive-compulsive disorder.

D) Obsessive-compulsive disorder impacts the family system, especially with impaired role function. How frequently or thoroughly the client cleans the house may be important to assess, but they are not the most important. Forgetfulness is not a component of obsessive-compulsive disorder.

Page Ref: 2098
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essential Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychosocial, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship Centered Care: Threats to the integrity of relationships, and the potential for conflict and abuse. | Nursing Process: Assessment
Learning Outcome: 31.C.7. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Apply the nursing process in providing culturally competent care to an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: A
Explanation:

A) The client who watches television while eating meals and engages in conversation with a roommate is exhibiting behavior that suggests treatment for obsessive-compulsive disorder is effective. This behavior is evidence of reduced anxiety and less of a need to engage in ritualistic behavior. The other observations would indicate the need for additional treatment.

B) The client who watches television while eating meals and engages in conversation with a roommate is exhibiting behavior that suggests treatment for obsessive-compulsive disorder is effective. This behavior is evidence of reduced anxiety and less of a need to engage in ritualistic behavior. The other observations would indicate the need for additional treatment.

C) The client who watches television while eating meals and engages in conversation with a roommate is exhibiting behavior that suggests treatment for obsessive-compulsive disorder is effective. This behavior is evidence of reduced anxiety and less of a need to engage in ritualistic behavior. The other observations would indicate the need for additional treatment.

D) The client who watches television while eating meals and engages in conversation with a roommate is exhibiting behavior that suggests treatment for obsessive-compulsive disorder is effective. This behavior is evidence of reduced anxiety and less of a need to engage in ritualistic behavior. The other observations would indicate the need for additional treatment.

Page Ref: 2100
Cognitive Level: Analyzing
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing Process: Evaluation
Learning Outcome: 31.C.4. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Identify the clinical manifestations of OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: C
Explanation:

A) Fluoxetine (Prozac) is one medication prescribed for the treatment of obsessive-compulsive disorder. Because the client is demonstrating continuing signs of the disorder, the nurse should assess if the client is taking the medication as prescribed. The client would have other signs and symptoms if taking too much medication. There are no specific foods to avoid when taking this medication. Continuing symptoms of obsessive-compulsive disorder is not a side effect of the medication.

B) Fluoxetine (Prozac) is one medication prescribed for the treatment of obsessive-compulsive disorder. Because the client is demonstrating continuing signs of the disorder, the nurse should assess if the client is taking the medication as prescribed. The client would have other signs and symptoms if taking too much medication. There are no specific foods to avoid when taking this medication. Continuing symptoms of obsessive-compulsive disorder is not a side effect of the medication.

C) Fluoxetine (Prozac) is one medication prescribed for the treatment of obsessive-compulsive disorder. Because the client is demonstrating continuing signs of the disorder, the nurse should assess if the client is taking the medication as prescribed. The client would have other signs and symptoms if taking too much medication. There are no specific foods to avoid when taking this medication. Continuing symptoms of obsessive-compulsive disorder is not a side effect of the medication.

D) Fluoxetine (Prozac) is one medication prescribed for the treatment of obsessive-compulsive disorder. Because the client is demonstrating continuing signs of the disorder, the nurse should assess if the client is taking the medication as prescribed. The client would have other signs and symptoms if taking too much medication. There are no specific foods to avoid when taking this medication. Continuing symptoms of obsessive-compulsive disorder is not a side effect of the medication.

Page Ref: 2097
Cognitive Level: Analyzing
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.5. Examine common barriers to active involvement of patients in their own health care processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. | Nursing Process: Assessment
Learning Outcome: 31.C.5. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Summarize diagnostic tests and therapies used by interdisciplinary teams in the collaborative care of an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: D
Explanation:

A) The client with obsessive-compulsive behavior will not be able to perform the behavior at will, so the nurse needs to discuss the need to incorporate the behavior with other hospital routines. The nurse should not interrupt the behavior, as this will cause the client to start over from the beginning. The nurse should also not confront the client and ask what purpose it serves, as the client might be embarrassed about the behavior. Telling the client that the behavior is unacceptable and must end also will not help the client with the behavior.

B) The client with obsessive-compulsive behavior will not be able to perform the behavior at will, so the nurse needs to discuss the need to incorporate the behavior with other hospital routines. The nurse should not interrupt the behavior, as this will cause the client to start over from the beginning. The nurse should also not confront the client and ask what purpose it serves, as the client might be embarrassed about the behavior. Telling the client that the behavior is unacceptable and must end also will not help the client with the behavior.

C) The client with obsessive-compulsive behavior will not be able to perform the behavior at will, so the nurse needs to discuss the need to incorporate the behavior with other hospital routines. The nurse should not interrupt the behavior, as this will cause the client to start over from the beginning. The nurse should also not confront the client and ask what purpose it serves, as the client might be embarrassed about the behavior. Telling the client that the behavior is unacceptable and must end also will not help the client with the behavior.

D) The client with obsessive-compulsive behavior will not be able to perform the behavior at will, so the nurse needs to discuss the need to incorporate the behavior with other hospital routines. The nurse should not interrupt the behavior, as this will cause the client to start over from the beginning. The nurse should also not confront the client and ask what purpose it serves, as the client might be embarrassed about the behavior. Telling the client that the behavior is unacceptable and must end also will not help the client with the behavior.

Page Ref: 2099
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing Process: Implementation
Learning Outcome: 31.C.7. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Apply the nursing process in providing culturally competent care to an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: B, D
Explanation:

A) Repeatedly tapping both wrists on the bedside table and counting the floor tiles demonstrate common behaviors of a client whose obsession is symmetry. A client whose obsession is symmetry often demonstrates counting, ensuring orderliness of items, or fixation on maintaining symmetrical positioning of items, such as repeatedly tapping both wrists on the bedside table. On the other hand, a client whose obsession is cleaning typically demonstrates repetitive performance of decontamination practices, such as repetitive hand washing; avoidance of contamination, such as refusing to shake hands; or repetitive environmental cleaning, such as repeatedly cleaning the top of the bedside table.

B) Repeatedly tapping both wrists on the bedside table and counting the floor tiles demonstrate common behaviors of a client whose obsession is symmetry. A client whose obsession is symmetry often demonstrates counting, ensuring orderliness of items, or fixation on maintaining symmetrical positioning of items, such as repeatedly tapping both wrists on the bedside table. On the other hand, a client whose obsession is cleaning typically demonstrates repetitive performance of decontamination practices, such as repetitive hand washing; avoidance of contamination, such as refusing to shake hands; or repetitive environmental cleaning, such as repeatedly cleaning the top of the bedside table.

C) Repeatedly tapping both wrists on the bedside table and counting the floor tiles demonstrate common behaviors of a client whose obsession is symmetry. A client whose obsession is symmetry often demonstrates counting, ensuring orderliness of items, or fixation on maintaining symmetrical positioning of items, such as repeatedly tapping both wrists on the bedside table. On the other hand, a client whose obsession is cleaning typically demonstrates repetitive performance of decontamination practices, such as repetitive hand washing; avoidance of contamination, such as refusing to shake hands; or repetitive environmental cleaning, such as repeatedly cleaning the top of the bedside table.

D) Repeatedly tapping both wrists on the bedside table and counting the floor tiles demonstrate common behaviors of a client whose obsession is symmetry. A client whose obsession is symmetry often demonstrates counting, ensuring orderliness of items, or fixation on maintaining symmetrical positioning of items, such as repeatedly tapping both wrists on the bedside table. On the other hand, a client whose obsession is cleaning typically demonstrates repetitive performance of decontamination practices, such as repetitive hand washing; avoidance of contamination, such as refusing to shake hands; or repetitive environmental cleaning, such as repeatedly cleaning the top of the bedside table.
E) Repeatedly tapping both wrists on the bedside table and counting the floor tiles demonstrate common behaviors of a client whose obsession is symmetry. A client whose obsession is symmetry often demonstrates counting, ensuring orderliness of items, or fixation on maintaining symmetrical positioning of items, such as repeatedly tapping both wrists on the bedside table. On the other hand, a client whose obsession is cleaning typically demonstrates repetitive performance of decontamination practices, such as repetitive hand washing; avoidance of contamination, such as refusing to shake hands; or repetitive environmental cleaning, such as repeatedly cleaning the top of the bedside table.

Page Ref: 2097
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing Process: Assessment
Learning Outcome: 31.C.4. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Identify the clinical manifestations of OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: C
Explanation:

A) This statement indicates that the client understands instruction regarding this medication. A client should continue taking fluvoxamine (Luvox) for 1—2 years, at which time a physician may begin gradually tapering, while observing the client for symptom exacerbation. Fluvoxamine (Luvox) does have side effects; however, it has fewer side effects than clomipramine and is recommended for the first medication trial. Fluvoxamine (Luvox) is approved by the U.S. Food and Drug Administration (FDA) for treatment of OCD.

B) This statement indicates that the client understands instruction regarding this medication. A client should continue taking fluvoxamine (Luvox) for 1—2 years, at which time a physician may begin gradually tapering, while observing the client for symptom exacerbation. Fluvoxamine (Luvox) does have side effects; however, it has fewer side effects than clomipramine and is recommended for the first medication trial. Fluvoxamine (Luvox) is approved by the U.S. Food and Drug Administration (FDA) for treatment of OCD.

C) This statement indicates that the client understands instruction regarding this medication. A client should continue taking fluvoxamine (Luvox) for 1—2 years, at which time a physician may begin gradually tapering, while observing the client for symptom exacerbation. Fluvoxamine (Luvox) does have side effects; however, it has fewer side effects than clomipramine and is recommended for the first medication trial. Fluvoxamine (Luvox) is approved by the U.S. Food and Drug Administration (FDA) for treatment of OCD.

D) This statement indicates that the client understands instruction regarding this medication. A client should continue taking fluvoxamine (Luvox) for 1—2 years, at which time a physician may begin gradually tapering, while observing the client for symptom exacerbation. Fluvoxamine (Luvox) does have side effects; however, it has fewer side effects than clomipramine and is recommended for the first medication trial. Fluvoxamine (Luvox) is approved by the U.S. Food and Drug Administration (FDA) for treatment of OCD.

Page Ref: 2098
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.11. Examine nursing roles in assuring coordination, integration, and continuity of care. | AACN Essential Competencies: IX.10 Facilitate patient-centered transitions of care, including discharge planning and ensuring the caregiver's knowledge of care requirements to promote safe care. | NLN Competencies: Relationship Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing Process: Evaluation
Learning Outcome: 31.C.5. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Summarize diagnostic tests and therapies used by interdisciplinary teams in the collaborative care of an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: C
Explanation:

A) The client who acknowledges improvement when washing hands less frequently recognizes that continued obsessive-compulsive behaviors are not an indication of treatment failure and that reductions in behavior signify positive progress. The client who has substituted the ritualistic use of hand sanitizer for the ritualistic hand washing has not demonstrated adequate coping skills to control anxiety related to absence of ritualistic compulsive behaviors. The client who sees nothing wrong with washing hands several times a day does not recognize that the ritualistic hand washing is a problem.

B) The client who acknowledges improvement when washing hands less frequently recognizes that continued obsessive-compulsive behaviors are not an indication of treatment failure and that reductions in behavior signify positive progress. The client who has substituted the ritualistic use of hand sanitizer for the ritualistic hand washing has not demonstrated adequate coping skills to control anxiety related to absence of ritualistic compulsive behaviors. The client who sees nothing wrong with washing hands several times a day does not recognize that the ritualistic hand washing is a problem.

C) The client who acknowledges improvement when washing hands less frequently recognizes that continued obsessive-compulsive behaviors are not an indication of treatment failure and that reductions in behavior signify positive progress. The client who has substituted the ritualistic use of hand sanitizer for the ritualistic hand washing has not demonstrated adequate coping skills to control anxiety related to absence of ritualistic compulsive behaviors. The client who sees nothing wrong with washing hands several times a day does not recognize that the ritualistic hand washing is a problem.

D) The client who acknowledges improvement when washing hands less frequently recognizes that continued obsessive-compulsive behaviors are not an indication of treatment failure and that reductions in behavior signify positive progress. The client who has substituted the ritualistic use of hand sanitizer for the ritualistic hand washing has not demonstrated adequate coping skills to control anxiety related to absence of ritualistic compulsive behaviors. The client who sees nothing wrong with washing hands several times a day does not recognize that the ritualistic hand washing is a problem.

Page Ref: 2100
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential Competencies: IX.13 Revise the plan of care based on an ongoing evaluation of patient outcomes. | NLN Competencies: Relationship Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing Process: Evaluation
Learning Outcome: 31.C.7. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Apply the nursing process in providing culturally competent care to an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: C
Explanation:

A) A malfunction in the cortico-striato-thalamo-cortical (CSTC) circuit in the brain is the possible cause for OCD. A malfunction in the other pathways contributes to other conditions or diseases, but they have not been linked to OCD.

B) A malfunction in the cortico-striato-thalamo-cortical (CSTC) circuit in the brain is the possible cause for OCD. A malfunction in the other pathways contributes to other conditions or diseases, but they have not been linked to OCD.

C) A malfunction in the cortico-striato-thalamo-cortical (CSTC) circuit in the brain is the possible cause for OCD. A malfunction in the other pathways contributes to other conditions or diseases, but they have not been linked to OCD.

D) A malfunction in the cortico-striato-thalamo-cortical (CSTC) circuit in the brain is the possible cause for OCD. A malfunction in the other pathways contributes to other conditions or diseases, but they have not been linked to OCD.

Page Ref: 2095-2096
Cognitive Level: Remembering
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing Process: Assessment
Learning Outcome: 31.C.1. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Describe the pathophysiology of OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: B
Explanation:

A) Without treatment, the rate of remission of OCD is estimated to be low. Therefore, treatment is essential; the disorder will not usually get better over time without treatment. Many individuals with OCD recognize that their obsessive thoughts are false or unlikely to happen, but that does not lessen their impact. Individuals with OCD perform compulsions to lessen anxiety, and they are often unable to control whether or not they perform the actions.

B) Without treatment, the rate of remission of OCD is estimated to be low. Therefore, treatment is essential; the disorder will not usually get better over time without treatment. Many individuals with OCD recognize that their obsessive thoughts are false or unlikely to happen, but that does not lessen their impact. Individuals with OCD perform compulsions to lessen anxiety, and they are often unable to control whether or not they perform the actions.

C) Without treatment, the rate of remission of OCD is estimated to be low. Therefore, treatment is essential; the disorder will not usually get better over time without treatment. Many individuals with OCD recognize that their obsessive thoughts are false or unlikely to happen, but that does not lessen their impact. Individuals with OCD perform compulsions to lessen anxiety, and they are often unable to control whether or not they perform the actions.

D) Without treatment, the rate of remission of OCD is estimated to be low. Therefore, treatment is essential; the disorder will not usually get better over time without treatment. Many individuals with OCD recognize that their obsessive thoughts are false or unlikely to happen, but that does not lessen their impact. Individuals with OCD perform compulsions to lessen anxiety, and they are often unable to control whether or not they perform the actions.

Page Ref: 2096, 2098
Cognitive Level: Understanding
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care: Patient/family/community preferences, values; Coordination and integration of care; Information, communication, and education; Physical comfort and emotional support; Involvement of family and friends Transition and continuity. | AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental state, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship Centered Care: Effective communication. | Nursing Process: Evaluation
Learning Outcome: 31.C.2. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Describe the etiology of OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: A
Explanation:

A) Clients with contamination obsessions often have compulsions related to cleaning and washing, especially washing the hands. Continual exposure to water and cleansing agents may result in loss of skin integrity. Assessment for sexual activity or religious beliefs would be more important if the client had aggressive, sexual, or religious obsessions. Assessment for tics would be more important for individuals with symmetry obsessions.

B) Clients with contamination obsessions often have compulsions related to cleaning and washing, especially washing the hands. Continual exposure to water and cleansing agents may result in loss of skin integrity. Assessment for sexual activity or religious beliefs would be more important if the client had aggressive, sexual, or religious obsessions. Assessment for tics would be more important for individuals with symmetry obsessions.

C) Clients with contamination obsessions often have compulsions related to cleaning and washing, especially washing the hands. Continual exposure to water and cleansing agents may result in loss of skin integrity. Assessment for sexual activity or religious beliefs would be more important if the client had aggressive, sexual, or religious obsessions. Assessment for tics would be more important for individuals with symmetry obsessions.

D) Clients with contamination obsessions often have compulsions related to cleaning and washing, especially washing the hands. Continual exposure to water and cleansing agents may result in loss of skin integrity. Assessment for sexual activity or religious beliefs would be more important if the client had aggressive, sexual, or religious obsessions. Assessment for tics would be more important for individuals with symmetry obsessions.

Page Ref: 2100
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: III.A.2. Describe EBP to include the components of research evidence, clinical expertise and patient/family values. | AACN Essential Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing Process: Assessment
Learning Outcome: 31.C.7. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Apply the nursing process in providing culturally competent care to an individual with OCD.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: B
Explanation:

A) Studies indicate that children and adolescents are more likely than adults to suffer rage attacks in relation to their OCD, a phenomenon that is enhanced if their family accommodates or reinforces their OCD behaviors. Telling the mother about this link can help the parents see the need to change their actions, which may eventually help decrease the rage attacks in public. Not taking the child out in public, reinforcing the behaviors in public, or immediately disciplining the child will not be beneficial to the child.

B) Studies indicate that children and adolescents are more likely than adults to suffer rage attacks in relation to their OCD, a phenomenon that is enhanced if their family accommodates or reinforces their OCD behaviors. Telling the mother about this link can help the parents see the need to change their actions, which may eventually help decrease the rage attacks in public. Not taking the child out in public, reinforcing the behaviors in public, or immediately disciplining the child will not be beneficial to the child.

C) Studies indicate that children and adolescents are more likely than adults to suffer rage attacks in relation to their OCD, a phenomenon that is enhanced if their family accommodates or reinforces their OCD behaviors. Telling the mother about this link can help the parents see the need to change their actions, which may eventually help decrease the rage attacks in public. Not taking the child out in public, reinforcing the behaviors in public, or immediately disciplining the child will not be beneficial to the child.

D) Studies indicate that children and adolescents are more likely than adults to suffer rage attacks in relation to their OCD, a phenomenon that is enhanced if their family accommodates or reinforces their OCD behaviors. Telling the mother about this link can help the parents see the need to change their actions, which may eventually help decrease the rage attacks in public. Not taking the child out in public, reinforcing the behaviors in public, or immediately disciplining the child will not be beneficial to the child.

Page Ref: 2098
Cognitive Level: Analyzing
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: III.A.2. Describe EBP to include the components of research evidence, clinical expertise and patient/family values. | AACN Essential Competencies: IX.7 Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing Process: Implementation
Learning Outcome: 31.C.6. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Differentiate considerations for care of clients with OCD across the lifespan.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.
Answer: B
Explanation:

A) The comorbidity of obsessive-compulsive symptoms and other mental disorders may interfere with responsiveness to treatment and increase the time it takes for medications to be effective in older adults. The obsessive-compulsive symptoms do still need to be treated in the older adult, even though they are subclinical. Although older adult clients with multiple mental health disorders should be assessed for dementia, the assessments do not need to be performed more frequently than normal. Older adults often need lower doses of medication because of an increased risk of side effects.

B) The comorbidity of obsessive-compulsive symptoms and other mental disorders may interfere with responsiveness to treatment and increase the time it takes for medications to be effective in older adults. The obsessive-compulsive symptoms do still need to be treated in the older adult, even though they are subclinical. Although older adult clients with multiple mental health disorders should be assessed for dementia, the assessments do not need to be performed more frequently than normal. Older adults often need lower doses of medication because of an increased risk of side effects.

C) The comorbidity of obsessive-compulsive symptoms and other mental disorders may interfere with responsiveness to treatment and increase the time it takes for medications to be effective in older adults. The obsessive-compulsive symptoms do still need to be treated in the older adult, even though they are subclinical. Although older adult clients with multiple mental health disorders should be assessed for dementia, the assessments do not need to be performed more frequently than normal. Older adults often need lower doses of medication because of an increased risk of side effects.

D) The comorbidity of obsessive-compulsive symptoms and other mental disorders may interfere with responsiveness to treatment and increase the time it takes for medications to be effective in older adults. The obsessive-compulsive symptoms do still need to be treated in the older adult, even though they are subclinical. Although older adult clients with multiple mental health disorders should be assessed for dementia, the assessments do not need to be performed more frequently than normal. Older adults often need lower doses of medication because of an increased risk of side effects.

Page Ref: 2098
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity
Standards: QSEN Competencies: III.A.2. Describe EBP to include the components of research evidence, clinical expertise and patient/family values. | AACN Essential Competencies: IX.9 Monitor client outcomes to evaluate the effectiveness of psychobiological interventions. | NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten health. | Nursing Process: Planning
Learning Outcome: 31.C.6. Analyze obsessive-compulsive disorder (OCD) as it relates to stress and coping. Differentiate considerations for care of clients with OCD across the lifespan.
MNL LO: Demonstrate understanding of the concept of stress and coping in the care of a patient with obsessive-compulsive disorder.