NSG221/ NSG 221 Exam 3: (Latest 2024/ 2025 Update) Mental Health Review| Questions and Verified Answers| 100% Correct| Grade A – Herzing
Q: The nurse is caring for a client who performs ritualistic hand washing and cleaning for about 30 minutes several times a day. What does the nurse tell the...
NSG221/ NSG 221 Exam 3: (Latest 2024/ 2025 Update) Mental Health Review| Questions and Verified Answers| 100% Correct| Grade A – Herzing Q: The nurse is caring for a client who performs ritualistic hand washing and cleaning for about 30 minutes several times a day. What does the nurse tell the client's partner about caring for this client? Answer: - Monitor own health and anxiety levels. Rationale: The nurse asks the client's partner to monitor the partner's own health and anxiety levels. The partner may benefit from an occasional break in the routine. The client must undergo therapy to complete daily activities without assistance. Diverti ng the client's attention to other activities or ignoring the client's behavior does not help either of them. The partner must understand the client's problem and encourage the client to undergo behavior therapy and take medications. Q: The nurse is assessing an older client with late onset of obsessive -compulsive disorder (OCD). What assessment does the nurse perform for this client? Select all that apply. Answer: - Assess for degenerative disorders. - Assess for possible brain injury. - Obtain history of recent infections. Rationale: Late onset of OCD may be triggered by an organic cause such degenerative disorders, infections, or brain injury. The nurse must alert the health care provider about the cause for the disorder. The nurse does not assess the client for onychophagi a or nail biting. This disorder begins in childhood and subsides by age 18 for most clients. Clients with an early onset of OCD have a greater likelihood of family history of OCD. OCD other than hoarding rarely manifests after the age of 50. Q: What question by the nurse is focused on identifying oniomaniac tendencies in a client diagnosed with depression? Answer: - "Do you get enjoyment out of all the clothes you buy?" Rationale: Oniomania, or compulsive buying, is an acquisition type of reward -seeking behavior. The pleasure is in acquiring the purchased object rather than any subsequent enjoyment of its use. Once acquired, the object may be infrequently or never used. T he person demonstrating oniomaniac behaviors is not usually suicidal. Kleptomania is compulsive stealing while body identity integrity disorder (BIID) involves the removal or amputation of alienated body parts. Q: A teenager and the teenager's parents visit the clinic to discuss the teen's skin picking. There are many bleeding wounds and various stages of scabs located up and down both arms. The parents are very upset about this behavior and want it to stop. Which w ould the health care provider document? Answer: - Excoriation disorder Rationale: Excoriation disorder (skin picking) is the inability to stop recurrent picking at skin for emotional release or anxiety release. Body dysmorphic disorder is a preoccupation with slight or imagined physical defects that are not apparent to others . There is not enough information to diagnose disrupted family dynamics or control issues within the family unit. Q: The nurse is interviewing the parents of a child who is exhibiting obsessive -compulsive disorder (OCD). The nurse would anticipate that the parents would report the occurrence of which situation with the child? Answer: - Failing classes due to a lack of concentration. Rationale: Assessment reveals intact intellectual functioning. The client may describe difficulty concentrating or paying attention when obsessions are strong. Because children subscribe to myths, superstition, and magical thinking, obsessive and ritualist ic behaviors may go unnoticed. Behaviors such as touching every third tree, avoiding cracks in the sidewalk, or consistently verbalizing fears of losing a parent in an accident may have some underlying pathology but are common behaviors in childhood. Typic ally, parents notice that a child's grades begin to fall as a result of decreased concentration and great amounts of time spent performing rituals. Isolating themselves, staring off into space, and being nervous could be considered normal behavior at certain developmental ages. Q: The nurse is assessing the physiological effects of severe obsessive -compulsive disorder (OCD) in a client. What does the nurse expect to find during assessment? Answer: - The client is unable to maintain adequate personal hygiene. Rationale: In severe OCD, the client is unable to complete routine tasks because of compulsive ritual behaviors. A lot of time is spent on performing rituals and the client may not have enough time to sleep. The client is so obsessed with thoughts and comp ulsive behaviors that physical needs such as sleep, food, drink, and hygiene are neglected. Thus, the client may report unwanted weight loss. Rituals also interfere with the client's ability to complete activities quickly. Q: What signs of stabilization does the nurse recognize during the follow -up visit of a client undergoing behavior therapy for obsessive -compulsive disorder (OCD)? Answer: - The client completes daily routine within a specified time. Rationale: The client who has achieved stabilization following behavior therapy for OCD is able to complete the daily routine within a specified time. The other outcomes are expected in a client in the immediate phase of behavior therapy. In that phase, th e client is able to identify stresses and anxieties, talk to the nurse about conflicting thoughts and fears and, with nursing staff help, recognize personal strengths and abilities. Q: What intervention does the nurse perform to assist the client in decreasing the frequency of repetitive behaviors? Answer: - Assist the client to keep a record of when time is used in performing activities. Rationale: The nurse should teach the client to keep a record of the frequency of and time used to perform activities. This helps the client to observe the decrease, an improvement in the condition. The client who avoids people and has limited social conta ct is taught conversation and attentive listening. The nurse helps the client who needs long -therapy to identify supportive resources in the community. The client is usually agitated when repeated behaviors are interrupted by others in an attempt to reduce the time taken for activities. Q: Which goal is appropriate for the client being treated for obsessive -compulsive disorder with response prevention therapy? Answer: - The client will experience notably less anxiety when engaged in delaying the ritual within 3 months. Rationale: Response prevention focuses on delaying or avoiding performance of rituals. The client learns to tolerate the thoughts and the anxiety and to recognize that it will recede without the disastrous imagined consequences. Other techniques, such as d eep breathing and relaxation, can also assist the person to tolerate and eventually manage the anxiety. Exposure involves assisting the client to deliberately confront the situations and stimuli that he or she usually avoids. Q: What interventions does the nurse use to promote therapeutic communication with the client diagnosed with obsessive -compulsive disorder (OCD)? Answer: - Explore the thoughts and feelings that trouble the client. Rationale: The nurse discusses the client's thoughts and feelings in as much detail as possible. This helps to relieve the client of some of the "burden" the client has been keeping to the self. The client is aware that the anxiety is irrational. The nurse validates the irresistible feelings that the client experiences but assures the client that these can be controlled. OCD clients tend to hide their rituals and obsessions from friends and family. However, discussing them with the nurse is an important ste p in treatment. Q: The nurse is assessing a teenage client with onychophagia. What does the nurse teach the parent about the disorder?
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