Chapter 26: Obsessive Compulsive and Related Disorders

1. A client 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.

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

2. A client with obsessive-compulsive disorder (OCD) is using cue cards to help restructure thought patterns. Which statements 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.

A) These are the OCD thoughts.

B) Trust myself.

E) I did it right the first time.

6. The nurse has identified a nursing diagnosis of disturbed thought processes for a patient with obsessive compulsive disorder. What abilities displayed by the patient would be related to an appropriate outcome

for this problem? Select all that apply.

A) Can identify when obsessions are worsening

B) Speaks of obsessions as being embarrassing behaviors

C) Describes lessening anxiety when compulsive rituals are interrupted

D) Plans to ignore obsessive thoughts and so minimizes resulting stress

E) Limits time focusing on obsessive thoughts to 15 minutes, 4 times a day

A) Can identify when obsessions are worsening

C) Describes lessening anxiety when compulsive rituals are interrupted

E) Limits time focusing on obsessive thoughts to 15 minutes, 4 times a day

3. 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

A) Clomipramine

C) Sertraline

D) Fluvoxamine

E) Paroxetine

5. The nurse is working with the family of a patient with obsessive-compulsive disorder (OCD). Which concept should the nurse incorporate in the teaching plan?

A) The thoughts, images, and impulses are voluntary.

B) The family should pay immediate attention to symptoms.

C) The thoughts, images, and impulses tend to worsen with stress.

D) OCD is a chronic disorder that does not respond to treatment.

C) The thoughts, images, and impulses tend to worsen with stress.

4. A woman diagnosed with obsessive-compulsive disorder comes to the clinic with her husband. During the visit, the husband states, She's always 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? An understanding of which of the following 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 woman's behavior reflects a need for safety.

D) The woman is attempting to use thought stopping to decrease her behavior.

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