Boyd Exam Prep Obsessive-Compulsive Disorders Chapter 28

Chapter 28: Obsessive-Compulsive and Related Disorders: Nursing Care of Persons with Obsessions and Compulsions

Format: Multiple Choice

Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Apply

Integrated Process: Teaching/Learning

Objective: 6

Page and Header: 501, Management of Complications; 503, Box 28.5

1. A client diagnosed with obsessive-compulsive disorder has been taking fluoxetine for 1 month. The client tells the nurse, “These pills are making me sick. I think I’m getting a brain tumor because of the headaches.” Which response by the nurse would be most appropriate?

A) “Let’s talk about how often you have been performing the rituals lately.”

B) “Tell me how many times you have washed your hands today.”

C) “Have you been practicing your deep breathing and relaxation exercises?”

D) “These medications have side effects that can cause increased headaches.”

Page and Header: 489, Compulsions

2. 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 is 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?

A) The client is attempting to exert control over the situation.

B) The client performs the ritual to relieve anxiety temporarily.

C) The client’s behavior reflects a need for safety.

D) The client is attempting to use thought stopping to decrease the behavior.

Page and Header: 500, Medication Interventions

3. A client diagnosed with severe obsessive-compulsive disorder who has been unresponsive to other medications is prescribed a tricyclic antidepressant as part of the treatment plan. Which agent would the nurse anticipate being prescribed?

A) Sertraline

B) Fluvoxamine

C) Fluoxetine

D) Clomipramine

Page and Header: 508, Hoarding Disorder

4. A client diagnosed with obsessive-compulsive disorder engages in storing many items that are considered to be useless. The nurse would categorize the client’s symptoms as belonging to which symptom dimension?

A) Symmetry/ordering/arranging

B) Aggressive/sexual/religious/checking

C) Contamination/cleaning

D) Collecting/hoarding

Page and Header: 494, Safety Issues

5. During an interview, a client diagnosed with obsessive-compulsive disorder tells the nurse, “I’m constantly worrying that something bad will happen to my mother and that she will die. So, I’m always praying so that this won’t happen.” The nurse interprets this as which obsessive-compulsive symptom dimension?

A) Symmetry/ordering/arranging

B) Aggressive/sexual/religious/checking

C) Contamination/cleaning

D) Collecting/hoarding

Page and Header: 493, Behavioral Factors

6. A psychiatric–mental health nurse is reading a journal article about obsessive-compulsive disorder (OCD) and the theories associated with its etiology. Which aspect would the nurse expect to be described as a behavioral explanation for the disorder?

A) Isolation

B) Undoing

C) Reaction formation

D) Conditioned stimuli

Page and Header: 497, Mental Status and Appearance

7. A psychiatric–mental health nurse is assessing a client and suspects that the client is experiencing obsessive-compulsive disorder. Which finding would support the nurse’s suspicion?

A) Client appears disheveled in appearance.

B) Speech is fairly loud and rapid.

C) Client includes irrelevant details in answers.

D) Client reports minimal physical symptoms.

Page and Header: 499, Maintaining Skin Integrity

8. A psychiatric–mental health nurse is working with a client diagnosed with obsessive-compulsive disorder (OCD). The client engages in an intense handwashing ritual, usually once an hour. Which intervention would be most appropriate for the nurse to include in a teaching plan for this client?

A) Use cold water when washing hands.

B) Apply hand cream to the skin after washing.

C) Use a strong antibacterial soap for washing.

D) Set up a schedule to wash hands every 20 minutes.

Page and Header: 500, Medication Interventions, Table 28.3

9. A psychiatric–mental health nurse is teaching a client with obsessive-compulsive disorder (OCD) about the prescribed antidepressant therapy. Which statement by the client indicates the need for additional teaching?

A) “I should notice a difference in a couple of days.”

B) “I should not stop the medicine abruptly.”

C) “I need to be careful because I might get sleepy at first.”

D) “I should not drink any alcohol while I’m taking this medicine.”

Page and Header: 507, Body Dysmorphic Disorder

10. A client is diagnosed with body dysmorphic disorder. When developing the plan of care for this client, which treatment would the nurse identify as the primary approach?

A) Antidepressant therapy

B) Cognitive-behavioral therapy

C) Psychosurgery

D) Electroconvulsive therapy

Page and Header: 507, Diagnostic Criteria

11. A psychiatric–mental health nurse is conducting a program for a group of nurses working at a primary care center about obsessive-compulsive disorder. One of the nurses asks, “So how would we know if the person’s routine is a compulsion?” Which response by the nurse would be most appropriate?

A) “If the routine interferes with the person’s normal activities, then it would be considered a compulsion.”

B) “If the person can control the ritual at one time, but not at another time, then the ritual is a compulsion.”

C) “If the ritual causes anxiety while the person is doing it, then it would be considered a compulsion.”

D) “Any ritual or routine is a considered a compulsion if it takes up at least 30 minutes a day.”

Page and Header: 509, Summary of Key Points

12. A nurse is reading a journal article about obsessive-compulsive disorder. Which obsession would the nurse note as being the most common?

A) Fear of contamination

B) Pathologic doubt

C) Thoughts of sexual images

D) Need for symmetry

Page and Header: 503, Exposure and Response Prevention

13. A client diagnosed with obsessive-compulsive disorder is receiving treatment that involves being subjected to situations that are known to trigger anxiety. The client is asked not to engage in performing the ritual behavior. Which type of therapy is being used?

A) Thought stopping

B) Cognitive restructuring

C) Exposure and response prevention

D) Cue cards

Page and Header: 503, Personalized Cue Cards/Cognitive Coping Cards; 504, Box 28.6

14. A client diagnosed with obsessive-compulsive disorder (OCD) is using cue cards to help restructure thought patterns. Which statement would be appropriate to include on a cue card? Select all that apply.

A) “These are the OCD thoughts.”

B) “Trust myself.”

C) “Keep on checking.”

D) “Safety is the key.”

E) “I did it right the first time.”

Page and Header: 500, Medication Interventions, Table 28.3

15. A client is diagnosed with obsessive-compulsive disorder (OCD) and is to receive medication therapy. Which of the following agents might the nurse expect to be prescribed? Select all that apply.

A) Clomipramine

B) Lithium

C) Sertraline

D) Fluvoxamine

E) Paroxetine

F) Alprazolam

Page and Header: 507, Body Dysmorphic Disorder

16. A psychiatric–mental health nurse is preparing an in-service program about dysmorphic disorder (BDD) for a group of nurses working at the community mental health center. When describing this disorder, which information would the nurse include? Select all that apply.

A) BDD primarily affects middle-aged adults.

B) More males than females are affected by BDD.

C) Clients with BDD commonly experience depression.

D) Self-medicating is a frequent practice in clients with BDD.

E) Personality disorders are highly prevalent in clients with BDD.

Page and Header: 507, Excoriation (Skin-Picking) Disorder

17. A nurse is assessing a client with excoriation disorder. At which site would the nurse most commonly expect to assess damage? Select all that apply.

A) Face

B) Arms

C) Hands

D) Joints

E) Lower legs

Page and Header: 507, Body Dysmorphic Disorder

18. While assessing a client diagnosed with body dysmorphic disorder, the nurse would also be alert for signs and symptoms of which condition? Select all that apply.

A) Eating disorder

B) Obsessive-compulsive disorder

C) Depression

D) Suicide ideation

E) Trichotillomania

Page and Header: 493, Recovery-Oriented Care for Persons with Obsessive-Compulsive Disorder; 499, Medication Interventions

19. A psychiatric–mental health nurse is developing a plan of care for a client just diagnosed with obsessive-compulsive disorder. Which intervention would the nurse most likely expect to include? Select all that apply.

A) Antidepressant medications

B) Cognitive-behavioral therapy

C) Supportive therapy

D) Electroconvulsive therapy

E) Psychosurgery

Page and Header: 501, Management of Complications; 503, Box 28.5

20. A client diagnosed with obsessive-compulsive disorder (OCD) is prescribed clomipramine. After teaching the client about the drug, the nurse determines that the teaching was successful when the client identifies which conditions as possible side effects of the drug? Select all that apply.

A) Sedation

B) Dry mouth

C) Increased libido

D) Ejaculation difficulty

E) Myalgia