NSG221 EXAM 3 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS LATEST UPDATE 2024/2025
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NSG221 EXAM 3 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS LATEST UPDATE 2024/2025
When assessing the insight and self-concept of a client with obsessive-compulsive disorder (OCD), what does the nurse note?
- The client has a fear of "going crazy."
Rationale: Clients with OCD express concern ...
When assessing the insight and self-concept of a client with obsessive-compulsive disorder (OCD),
what does the nurse note?
- The client has a fear of "going crazy."
Rationale: Clients with OCD express concern that they may be "going crazy." Feelings of powerlessness to
control the obsessions or compulusions contribute to their low self-esteem. These clients also feel that
they could control the thoughts and behaviors if they had stronger willpower. These clients are able to
make sound judgments but are unable to act on them. Clients with OCD are aware that the intrusive
images and thoughts are irrational, but they cannot control the overwhelming anxiety.
The nurse is caring for an adolescent with dermatillomania. What does the nurse tell the client's
parent about this disorder? Select all that apply.
- It can lead to loss of occupational functioning.
- It can lead to medical complications
- The client finds comfort in skin picking
Rationale: Dermatillomania is an obsessive-compulsive disorder (OCD) in which the client seeks comfort
in skin picking. This behavior can lead to the loss of occupational functioning if the client refuses to
,interact with others due to disfigurement. The condition can also lead to infections and other medical
complications. Dermatillomania is not caused by substance use nor is it a reward-seeking behavior.
The nurse is caring for a client with obsessive-compulsive disorder (OCD). What are the expected
outcomes for the client who has been stabilized by medication and behavior therapy?
- Continue follow-up therapy as needed.
Rationale: Clients with OCD who have been stabilized by medication and behavior therapy may
experience long-term difficulties in dealing with obsessive thoughts. These clients are encouraged to
continue follow-up therapy. The expected outcome for clients in the stabilization phase of therapy is
verbalizing knowledge of illness and treatment plan. In the immediate phase of therapy, clients should
be able to list and review strengths and abilities with the nursing staff. These clients should also be able
identify stresses and anxieties to enable the nurse to develop a plan of care.
The nurse is caring for a client undergoing cognitive behavior therapy for obsessive-compulsive
disorder. How does the cognitive model describe the client's thought process? Select all that apply
- The client has intolerance for uncertainty.
- The client overestimates the threats caused by the thoughts.
- The client wants to control own thoughts.
Rationale: According to the cognitive model, the person believes that "if I think, it will happen."
Therefore, the client wants to control the client's own thoughts. This client tries to be perfect and has
intolerance for uncertainty. The client feels threatened by the thoughts. All this causes an increased
anxiety in the client leading to some compulsive ritualistic behavior. As per the cognitive model, the
,client's thoughts are influenced by an inflated sense of responsibility. This may be a result of strict moral
or religious upbringing.
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."
Rationale: OCD is a chronic, progressive disease. Symptoms wax and wane over time, increasing during
periods of stress. While the other statements are accurate, they do not provide the most general,
encompassing information regarding the management of this chronic, progressive disorder.
A client's older parent has been diagnosed with hoarding disorder. What does the nurse instruct the
client about the parent's hoarding disorder?
- Treatment may involve community agencies.
Rationale: The treatment for hoarding disorder in the older adult may involve multiple community
agencies besides medications and behavior therapy. Hoarding disorder is an obsessive-compulsive
disorder (OCD) with a late-age onset; any other recently acquired OCD in the older client may be a
degenerative disorder or the result of an injury to the basal ganglia. Long-term, not short-term,
treatment can result in a successful outcome.
Which medication does the nurse anticipate the health care provider will prescribe for a client who is
beginning treatment for obsessive-compulsive disorder (OCD)?
, - Fluvoxamine
Rationale: The client who is beginning treatment for OCD is prescribed the selective serotonin reuptake
inhibitor depressant fluvoxamine as a first-line choice. Clients with treatment-resistant OCD may respond
to second-generation antipsychotics such as risperidone, quetiapine, and olanzapine.
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
Rationale: Compulsions are ritualistic or repetitive behaviors or mental acts that a person carries out
continuously in an attempt to neutralize anxiety. A phobia is an illogical, intense, persistent fear of a
specific object or a social situation that causes extreme distress and interferes with normal functioning.
An obsession is a recurrent, persistent, intrusive, and unwanted thought, image, or impulse that causes
marked anxiety and interference with interpersonal, social, or occupational function. Derealization is
sensing that things are not real.
The nurse is assessing a client recently diagnosed with obsessive-compulsive disorder (OCD). What
does the nurse tell the client about the onset of the disorder?
- Early onset may indicate family history of OCD
Rationale: Early onset of OCD indicates the likelihood of a family history of OCD. OCD starts in childhood
especially in males. In females the onset is in the 20s. OCD is diagnosed only when the client's
compulsive behavior interferes with the client's personal, social, and occupational function.
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