NUR 384 EXAM 4 QUESTIONS AND ANSWERS 2026
Which would be a reason for a student nurse to use the DSM?
A) Identifying the medical diagnosis
B) Treat clients
C) Evaluate treatments
D) Understand the reason for the admission and the nature of psychiatric illnesses -
Answers - Ans: D
Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a
helpful resource to understand the reason for the admission and to begin building
knowledge about the nature of psychiatric illnesses. Identifying the medical diagnosis,
treating, and evaluating treatments are not a part of the nursing process.
A new graduate nurse has accepted a staff position at an inpatient mental health facility.
The graduate nurse can expect to be responsible for basic-level functions, including
A) providing clinical supervision.
B) using effective communication skills.
C) adjusting client medications.
D) directing program development. - Answers - Ans: B
Feedback:
Basic-level functions include counseling, milieu therapy, self-care activities,
psychobiologic interventions, health teaching, case management, and health promotion
and maintenance. Advanced-level functions include psychotherapy, prescriptive
authority for drugs, consultation and liaison, evaluation, program development and
management, and clinical supervision.
The nursing student understands correctly when identifying which objective is
appropriate for all clients with anxiety disorders?
A) The client will experience reduced anxiety and accept the fact that underlying
conflicts cannot be treated.
B) The client will experience reduced anxiety and develop alternative responses to
anxiety-provoking situations.
C) The client will experience reduced anxiety and learn to control primitive impulses.
D) The client will experience reduced anxiety and strive for insight through
psychoanalysis - Answers - Ans: B
Feedback:
A primary client outcome is improved adaptive coping skills.
The nursing student correctly identifies which of the following statements are true of the
etiology of OCD? Select all that apply.
A) The cognitive model for OCD etiology focuses on childhood and environmental
experiences of growing up.
B) The etiology of OCD is not definitively explained at this time.
C) OCD is caused by immune dysfunction.
,D) The primary etiology of OCD is genetics. E) Cognitive models may partially explain
why people develop OCD - Answers - Ans: A, B, E
Feedback:
Different studies of the etiology of OCD show promise, but have yet to definitively
explain how or why people develop OCD. Cognitive models of OCD have been long
accepted as a partial explanation for OCD. The cognitive model focuses on childhood
and environmental experiences of growing up. Heritable, genetic factors are a
significant influence on thinking, and environmental influences are not solely
responsible. Immune dysfunction may play a role in the etiology of OCD.
Which of the following are features of the thinking of a person who has OCD according
to the cognitive model? Select all that apply.
A) The person with OCD employs a minimalist approach to all aspects of his or her life.
B) The person with OCD believes one's thoughts are overly important and has a need to
control those thoughts as they overestimate the threat posed by their thoughts.
C) The person with OCD is always aware that his or her behavior is related to OCD.
D) The person with OCD is concerned with perfectionism and has an intolerance of
uncertainty.
E) The person with OCD has an inflated personal responsibility - Answers - Ans: B, D, E
Feedback:
The cognitive model describes the person's thinking as (1) believing one's thoughts are
overly important; that is, If I think it, it will happen, and therefore having a need to control
those thoughts; (2) perfectionism and the intolerance of uncertainty; and (3) inflated
personal responsibility (from a strict moral or religious upbringing) and overestimation of
the threat posed by one's thoughts. The person with OCD would not employ a
minimalist approach to all aspects of his or her lifelore or she is likely to perform some
tasks at extreme levels. The persons with OCD may not always be aware that their
behavior is related to OCD.
The nurse correctly identifies that which of OCDs self-soothing behaviors may involve
self-destruction of the body of a person who has OCD? Select all that apply.
A) Dermatillomania
B) Trichotillomania
C) Onychophagia
D) Kleptomania
E) Oniomania - Answers - Ans: A, B, C
Feedback:
Dermatillomania, or skin-picking, is a self-soothing behavior; that is, the behavior is an
attempt of people to soothe or comfort themselves, not that picking itself is necessarily a
positive sensation. Trichotillomania, or chronic, repetitive hair pulling, is a self-soothing
behavior that can cause distress and functional impairment. Onychophagia, or nail
biting, is a self-soothing behavior. Kleptomania, or compulsive stealing, and oniomania,
or compulsive buying, are reward-seeking behaviors.
Which of the following statements about the typical history of illness that would be
assessed in a client who has OCD is consistent with OCD?
,A) OCD usually requires hospitalization.
B) OCD treatment is usually outpatient.
C) OCD only affects the client's ability to perform ADLs and work, not his or her leisure
life.
D) Most people seek treatment as soon as they observe the symptoms. - Answers -
Ans: B
Feedback:
The client usually seeks treatment only when obsessions become too overwhelming or
when compulsions interfere with daily life (work, ADLs, or leisure) or both. Clients are
hospitalized only when they have become completely unable to carry out their daily
routines. Most treatment is outpatient. The client often reports that rituals began many
years before; some begin as early as childhood. The more responsibility the client has
as he or she gets older, the more the rituals interfere with the ability to fulfill these
responsibilities.
Which of the following would be appropriate outcomes for a client with OCD? Select all
that apply.
A) The client will stop engaging in the compulsive activity.
B) The client will spend less time performing rituals.
C) The client will complete daily routine activities within a realistic time frame.
D) The client will conceal the behavior from all persons to avoid anxiety.
E) The client will demonstrate effective use of behavior therapy techniques. - Answers -
Ans: B, C, E
Feedback:
Outcomes for clients with OCD include the following: ï The client will complete daily
routine activities within a realistic time frame. ï The client will demonstrate effective use
of relaxation techniques. ï The client will discuss feelings with another person. ï The
client will demonstrate effective use of behavior therapy techniques. ï The client will
spend less time performing rituals.
Which of the following is the most important variable in determining the likelihood of
success in improving life for a client with OCD?
A) The client must be willing to make changes in his or her behavior. B) The client must
acknowledge that the behavior is not in his or her control.
C) The client must allow the nurse to decide the appropriate intervention for him or her.
D) The client must be willing to try all new relaxation techniques. - Answers - Ans: A
Feedback:
The most important variable is that the client is willing to make changes in his or her
behavior. The nurse must not interrupt the client from performing rituals as this will
cause anxiety, and the client will need to begin the ritual again. The client and nurse
together must determine which interventions will be used. The client will likely need to
use relaxation techniques but should have input into deciding which ones.
Which of the following is an important part of therapeutic communication for clients who
have OCD?
A) To encourage the client to keep the obsession secret.
, B) To encourage the client to discuss his or her obsession with the nurse.
C) The nurse must have the same obsession as the client.
D) The nurse must instruct the client to discuss the obsession - Answers - Ans: B
Feedback:
The nurse encourages the client to talk about the feelings and to describe them in as
much detail as the client can tolerate. Because many clients try to hide their rituals and
to keep obsessions secret, discussing these thoughts, behaviors, and resulting feelings
with the nurse is an important step. It is not necessary for the nurse to have the same
obsession as the client.
Before eating a meal, a client with obsessive compulsive disorder must wash her hands
for 14 minutes, comb her hair for 114 strokes, and switch the light off and on 44 times.
When evaluating the progress of the client, what is the most important treatment
objective for this client?
A) Allow ample time for completion of all rituals before each meal.
B) Gradually decrease the amount of time spent for performing rituals.
C) Increase the client's acceptance of the need for medication to control rituals.
D) Omit one ritualistic behavior every 4 days until all rituals are eliminated - Answers -
Ans: B
Feedback:
Treatment has been effective when OCD symptoms no longer interfere with the client's
ability to carry out responsibilities. When obsessions occur, the client manages resulting
anxiety without engaging in complicated or time-consuming rituals. He or she reports
regained control over his or her life and the ability to tolerate and manage anxiety with
minimal disruption. Ritualistic behaviors may be decreased gradually over time.
Which of the following treatment modalities is most effective for OCD?
A) Behavioral techniques
B) Medication
C) Behavioral techniques and medication
D) Ignoring it - Answers - Ans: C
Feedback:
Behavioral techniques and medication are the most effective treatment modalities for
OCD. This would be more effective than either behavioral techniques or medication
alone. It is not appropriate to ignore OCD as it will only get worse until the client is
unable to engage in activities of daily living.
Which of the following is essential for the nurse to communicate to the client with OCD
and to the client's family?
A) The client's diagnosis should be kept secret from everyone outside the immediate
family and friends.
B) The importance of medication compliance and that it may be necessary for
medication to be changed to find the one that works best.
C) It is important for the client to avoid following a routine.
D) It is helpful for others to give unsolicited advice about other activities the client with
OCD can engage in - Answers - Ans: B
Which would be a reason for a student nurse to use the DSM?
A) Identifying the medical diagnosis
B) Treat clients
C) Evaluate treatments
D) Understand the reason for the admission and the nature of psychiatric illnesses -
Answers - Ans: D
Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a
helpful resource to understand the reason for the admission and to begin building
knowledge about the nature of psychiatric illnesses. Identifying the medical diagnosis,
treating, and evaluating treatments are not a part of the nursing process.
A new graduate nurse has accepted a staff position at an inpatient mental health facility.
The graduate nurse can expect to be responsible for basic-level functions, including
A) providing clinical supervision.
B) using effective communication skills.
C) adjusting client medications.
D) directing program development. - Answers - Ans: B
Feedback:
Basic-level functions include counseling, milieu therapy, self-care activities,
psychobiologic interventions, health teaching, case management, and health promotion
and maintenance. Advanced-level functions include psychotherapy, prescriptive
authority for drugs, consultation and liaison, evaluation, program development and
management, and clinical supervision.
The nursing student understands correctly when identifying which objective is
appropriate for all clients with anxiety disorders?
A) The client will experience reduced anxiety and accept the fact that underlying
conflicts cannot be treated.
B) The client will experience reduced anxiety and develop alternative responses to
anxiety-provoking situations.
C) The client will experience reduced anxiety and learn to control primitive impulses.
D) The client will experience reduced anxiety and strive for insight through
psychoanalysis - Answers - Ans: B
Feedback:
A primary client outcome is improved adaptive coping skills.
The nursing student correctly identifies which of the following statements are true of the
etiology of OCD? Select all that apply.
A) The cognitive model for OCD etiology focuses on childhood and environmental
experiences of growing up.
B) The etiology of OCD is not definitively explained at this time.
C) OCD is caused by immune dysfunction.
,D) The primary etiology of OCD is genetics. E) Cognitive models may partially explain
why people develop OCD - Answers - Ans: A, B, E
Feedback:
Different studies of the etiology of OCD show promise, but have yet to definitively
explain how or why people develop OCD. Cognitive models of OCD have been long
accepted as a partial explanation for OCD. The cognitive model focuses on childhood
and environmental experiences of growing up. Heritable, genetic factors are a
significant influence on thinking, and environmental influences are not solely
responsible. Immune dysfunction may play a role in the etiology of OCD.
Which of the following are features of the thinking of a person who has OCD according
to the cognitive model? Select all that apply.
A) The person with OCD employs a minimalist approach to all aspects of his or her life.
B) The person with OCD believes one's thoughts are overly important and has a need to
control those thoughts as they overestimate the threat posed by their thoughts.
C) The person with OCD is always aware that his or her behavior is related to OCD.
D) The person with OCD is concerned with perfectionism and has an intolerance of
uncertainty.
E) The person with OCD has an inflated personal responsibility - Answers - Ans: B, D, E
Feedback:
The cognitive model describes the person's thinking as (1) believing one's thoughts are
overly important; that is, If I think it, it will happen, and therefore having a need to control
those thoughts; (2) perfectionism and the intolerance of uncertainty; and (3) inflated
personal responsibility (from a strict moral or religious upbringing) and overestimation of
the threat posed by one's thoughts. The person with OCD would not employ a
minimalist approach to all aspects of his or her lifelore or she is likely to perform some
tasks at extreme levels. The persons with OCD may not always be aware that their
behavior is related to OCD.
The nurse correctly identifies that which of OCDs self-soothing behaviors may involve
self-destruction of the body of a person who has OCD? Select all that apply.
A) Dermatillomania
B) Trichotillomania
C) Onychophagia
D) Kleptomania
E) Oniomania - Answers - Ans: A, B, C
Feedback:
Dermatillomania, or skin-picking, is a self-soothing behavior; that is, the behavior is an
attempt of people to soothe or comfort themselves, not that picking itself is necessarily a
positive sensation. Trichotillomania, or chronic, repetitive hair pulling, is a self-soothing
behavior that can cause distress and functional impairment. Onychophagia, or nail
biting, is a self-soothing behavior. Kleptomania, or compulsive stealing, and oniomania,
or compulsive buying, are reward-seeking behaviors.
Which of the following statements about the typical history of illness that would be
assessed in a client who has OCD is consistent with OCD?
,A) OCD usually requires hospitalization.
B) OCD treatment is usually outpatient.
C) OCD only affects the client's ability to perform ADLs and work, not his or her leisure
life.
D) Most people seek treatment as soon as they observe the symptoms. - Answers -
Ans: B
Feedback:
The client usually seeks treatment only when obsessions become too overwhelming or
when compulsions interfere with daily life (work, ADLs, or leisure) or both. Clients are
hospitalized only when they have become completely unable to carry out their daily
routines. Most treatment is outpatient. The client often reports that rituals began many
years before; some begin as early as childhood. The more responsibility the client has
as he or she gets older, the more the rituals interfere with the ability to fulfill these
responsibilities.
Which of the following would be appropriate outcomes for a client with OCD? Select all
that apply.
A) The client will stop engaging in the compulsive activity.
B) The client will spend less time performing rituals.
C) The client will complete daily routine activities within a realistic time frame.
D) The client will conceal the behavior from all persons to avoid anxiety.
E) The client will demonstrate effective use of behavior therapy techniques. - Answers -
Ans: B, C, E
Feedback:
Outcomes for clients with OCD include the following: ï The client will complete daily
routine activities within a realistic time frame. ï The client will demonstrate effective use
of relaxation techniques. ï The client will discuss feelings with another person. ï The
client will demonstrate effective use of behavior therapy techniques. ï The client will
spend less time performing rituals.
Which of the following is the most important variable in determining the likelihood of
success in improving life for a client with OCD?
A) The client must be willing to make changes in his or her behavior. B) The client must
acknowledge that the behavior is not in his or her control.
C) The client must allow the nurse to decide the appropriate intervention for him or her.
D) The client must be willing to try all new relaxation techniques. - Answers - Ans: A
Feedback:
The most important variable is that the client is willing to make changes in his or her
behavior. The nurse must not interrupt the client from performing rituals as this will
cause anxiety, and the client will need to begin the ritual again. The client and nurse
together must determine which interventions will be used. The client will likely need to
use relaxation techniques but should have input into deciding which ones.
Which of the following is an important part of therapeutic communication for clients who
have OCD?
A) To encourage the client to keep the obsession secret.
, B) To encourage the client to discuss his or her obsession with the nurse.
C) The nurse must have the same obsession as the client.
D) The nurse must instruct the client to discuss the obsession - Answers - Ans: B
Feedback:
The nurse encourages the client to talk about the feelings and to describe them in as
much detail as the client can tolerate. Because many clients try to hide their rituals and
to keep obsessions secret, discussing these thoughts, behaviors, and resulting feelings
with the nurse is an important step. It is not necessary for the nurse to have the same
obsession as the client.
Before eating a meal, a client with obsessive compulsive disorder must wash her hands
for 14 minutes, comb her hair for 114 strokes, and switch the light off and on 44 times.
When evaluating the progress of the client, what is the most important treatment
objective for this client?
A) Allow ample time for completion of all rituals before each meal.
B) Gradually decrease the amount of time spent for performing rituals.
C) Increase the client's acceptance of the need for medication to control rituals.
D) Omit one ritualistic behavior every 4 days until all rituals are eliminated - Answers -
Ans: B
Feedback:
Treatment has been effective when OCD symptoms no longer interfere with the client's
ability to carry out responsibilities. When obsessions occur, the client manages resulting
anxiety without engaging in complicated or time-consuming rituals. He or she reports
regained control over his or her life and the ability to tolerate and manage anxiety with
minimal disruption. Ritualistic behaviors may be decreased gradually over time.
Which of the following treatment modalities is most effective for OCD?
A) Behavioral techniques
B) Medication
C) Behavioral techniques and medication
D) Ignoring it - Answers - Ans: C
Feedback:
Behavioral techniques and medication are the most effective treatment modalities for
OCD. This would be more effective than either behavioral techniques or medication
alone. It is not appropriate to ignore OCD as it will only get worse until the client is
unable to engage in activities of daily living.
Which of the following is essential for the nurse to communicate to the client with OCD
and to the client's family?
A) The client's diagnosis should be kept secret from everyone outside the immediate
family and friends.
B) The importance of medication compliance and that it may be necessary for
medication to be changed to find the one that works best.
C) It is important for the client to avoid following a routine.
D) It is helpful for others to give unsolicited advice about other activities the client with
OCD can engage in - Answers - Ans: B
