NSG221/ NSG 221 Exam 3: (Latest 2024/ 2025 Update)
Mental Health Review| Questions and Verified Answers|
100% Correct| Grade A – Herzing
When assessing the insight and self-concept of a client with obsessive-compulsive
disorder (OCD), what does the nurse note? - ANSWER - 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. - ANSWER - 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? - ANSWER - 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 - ANSWER - 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? - ANSWER - "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? - ANSWER -
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)? -
ANSWER - 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? - ANSWER - 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? -
ANSWER - 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.
What interventions does the nurse perform when caring for a client with obsessive-
compulsive disorder (OCD)? Select all that apply. - ANSWER - Teach the client
social skills such as appropriate conversation topics.
- Encourage the client to perform activities of daily living within a fixed time.
- Teach the client to avoid trigger situations.
Rationale: Nursing interventions for OCD include encouraging the client to perform
activities of daily living within a fixed time, teaching the client social skills such as
appropriate conversation topics, and teaching the client to avoid trigger situations.
The nurse should not provide undue praise, such as rewarding the client for every
activity. Clients with OCD benefit from genuine praise that is earned. The nurse
should convey interest when speaking to the client; however, a calm, reassuring
voice is not necessary. This tone is used with clients experiencing a panic attack.
A client performs ritualistic washing of the hands and dishes, along with rearranging
the table before settling down to a meal. What intervention does the nurse implement
to help this client complete this daily routine? Select all that apply. - ANSWER -
Come to an agreement with the client on a time to stop the ritual.
- Encourage a gradual decrease in the time allotted for the ritual.
- Include the time taken for the ritual in the day's timetable.
Rationale: The nurse includes the time taken for the ritual while planning the client's
schedule. Exposure and response prevention techniques are successful only if the
client agrees to cooperate during the treatment. Therefore, the nurse and client
should agree on a time to stop the ritual and continue daily activities. It does not help
to create distractions by asking the client to perform another activity instead of the
daily ritual. The nurse does not interrupt the client during the ritual because this can
escalate the client's anxiety. The nurse supports and encourages the client to
gradually decrease the time allotted for the ritual each day. This helps to gradually
eliminate the client's ritualistic behavior.
Which statement by the nurse providing care for a client diagnosed with obsessive-
compulsive disorder (OCD), indicates a need for additional education regarding the
client's ritualistic hand washing? - ANSWER - "Let me help you find something less
time consuming to do to manage your anxiety."
Rationale: People with OCD are usually aware that their ritualistic behavior appear
senseless or even bizarre to others. Given that, family and friends may believe that
Mental Health Review| Questions and Verified Answers|
100% Correct| Grade A – Herzing
When assessing the insight and self-concept of a client with obsessive-compulsive
disorder (OCD), what does the nurse note? - ANSWER - 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. - ANSWER - 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? - ANSWER - 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 - ANSWER - 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? - ANSWER - "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? - ANSWER -
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)? -
ANSWER - 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? - ANSWER - 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? -
ANSWER - 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.
What interventions does the nurse perform when caring for a client with obsessive-
compulsive disorder (OCD)? Select all that apply. - ANSWER - Teach the client
social skills such as appropriate conversation topics.
- Encourage the client to perform activities of daily living within a fixed time.
- Teach the client to avoid trigger situations.
Rationale: Nursing interventions for OCD include encouraging the client to perform
activities of daily living within a fixed time, teaching the client social skills such as
appropriate conversation topics, and teaching the client to avoid trigger situations.
The nurse should not provide undue praise, such as rewarding the client for every
activity. Clients with OCD benefit from genuine praise that is earned. The nurse
should convey interest when speaking to the client; however, a calm, reassuring
voice is not necessary. This tone is used with clients experiencing a panic attack.
A client performs ritualistic washing of the hands and dishes, along with rearranging
the table before settling down to a meal. What intervention does the nurse implement
to help this client complete this daily routine? Select all that apply. - ANSWER -
Come to an agreement with the client on a time to stop the ritual.
- Encourage a gradual decrease in the time allotted for the ritual.
- Include the time taken for the ritual in the day's timetable.
Rationale: The nurse includes the time taken for the ritual while planning the client's
schedule. Exposure and response prevention techniques are successful only if the
client agrees to cooperate during the treatment. Therefore, the nurse and client
should agree on a time to stop the ritual and continue daily activities. It does not help
to create distractions by asking the client to perform another activity instead of the
daily ritual. The nurse does not interrupt the client during the ritual because this can
escalate the client's anxiety. The nurse supports and encourages the client to
gradually decrease the time allotted for the ritual each day. This helps to gradually
eliminate the client's ritualistic behavior.
Which statement by the nurse providing care for a client diagnosed with obsessive-
compulsive disorder (OCD), indicates a need for additional education regarding the
client's ritualistic hand washing? - ANSWER - "Let me help you find something less
time consuming to do to manage your anxiety."
Rationale: People with OCD are usually aware that their ritualistic behavior appear
senseless or even bizarre to others. Given that, family and friends may believe that
