OCD Case Study with DSM-5 Diagnosis, Symptoms
& Therapy – A+ Graded
A young female adult client is accompanied to a mental health assessment center for evaluation by her
parents. The client is wearing leggings and an oversized t-shirt. Hair is still damp from a shower with
which the mother said she had to assist. The nurse notes that the client's hands are red and chapped.
The mother states that the client washes her hands repeatedly. The client is crying as she leans on her
mother's shoulder. The client is pressured as she responds to the psychiatrist's questions and eye
contact is poor. The client denies any history of substance abuse, and the parents corroborate this
stating that the client rarely leaves the house. When asked what her biggest concern is, the client
responds that she just can't take it anymore and her mind won't stop the torture. The psychiatrist
recommends hospitalization and the client agrees to the admission. - ✔✔
The psychiatrist completes an assessment and admits the client to the inpatient adult unit. After the
admitting procedures are complete, the client's parents leave for home and the client immediately
becomes increasingly agitated, and begins crying and hyperventilating. The nurse informs the client that
the psychiatrist is writing prescriptions for medication to help alleviate the anxiety and will check on the
status of the prescription, and be back with the medication as soon as it is available.
Which nursing action is indicated next?
A. Check the client's EMR to see if the medication has been prescribed
B.Wait at least 15 minutes before giving any medication because the client's anxiety may be a short-
lived response to her parents leaving
C. Tell the client to lie down and try to relax until the nurse returns with the medication
D. Ask another nurse to check on the status of the medications prescribed and return - ✔✔D. Ask
another nurse to check on the status of the medications prescribed and return to the client's room and
stay with her
Rationale: Clients experiencing panic should not be left along. Safety concerns exist due to the client's
inability to think clearly. The nurse is more familiar to this client from the assessment intake, and should
be the one to stay with her rather than asking another staff member to do so.
The medication becomes available and the nurse partially opens the packet containing the oral
lorazepam 2 mg. The nurse empties the medication into a paper cup then hands the cup to the client
, with a glass of water. The client refuses to take the cup, and back away from the nurse stating, "I heard
you coughing earlier. I don't want to take it from you."
Which is an indicated response from the nurse in this situation? - ✔✔Empty the pill into the client's
hand without touching the pill.
Rationale: The client has high anxiety, so it is important that she receives medication to help her calm
down. The nurse assuring the client that she will use caution to not touch the pill may help the client
take it and demonstrates an understanding the client's OCD.
The nurse completes an initial nursing intake assessment. When asked what brought her to the hospital,
the client replies, "I can't stop worrying about everything. It's so bad I don't even want to get out of bed
anymore" and she begins to cry. The client admits to having OCD in the past and she had been taking
fluvoxamine for 4 years. She states she weaned herself off the medication 2 months ago because she
was starting college and the medication made her tired. The client states: "I couldn't handle college
though and now I feel like a big failure. I'm just taking up space. I'm no good to anyone."
Which nursing concern should take priority? - ✔✔Potential risk for suicide.
Rationale: Safety should always be the priority and a client is making statements that may indicate risk
for self-directed harm.
The nurse recognizes a need to educate the client on the dangers of stopping her medication without
the supervision of her psychiatrist. The nurse makes a decision to wait until a later time to provide this
education.
Which rationale is the basis for the nurse's decision? - ✔✔The client is currently experiencing severe to
panic levels of anxiety, so education will be ineffective.
Rationale: Clients who are experiencing severe or panic levels of anxiety will have difficulty
concentrating and processing information. Education should be delayed until such a time that a client
can focus.
& Therapy – A+ Graded
A young female adult client is accompanied to a mental health assessment center for evaluation by her
parents. The client is wearing leggings and an oversized t-shirt. Hair is still damp from a shower with
which the mother said she had to assist. The nurse notes that the client's hands are red and chapped.
The mother states that the client washes her hands repeatedly. The client is crying as she leans on her
mother's shoulder. The client is pressured as she responds to the psychiatrist's questions and eye
contact is poor. The client denies any history of substance abuse, and the parents corroborate this
stating that the client rarely leaves the house. When asked what her biggest concern is, the client
responds that she just can't take it anymore and her mind won't stop the torture. The psychiatrist
recommends hospitalization and the client agrees to the admission. - ✔✔
The psychiatrist completes an assessment and admits the client to the inpatient adult unit. After the
admitting procedures are complete, the client's parents leave for home and the client immediately
becomes increasingly agitated, and begins crying and hyperventilating. The nurse informs the client that
the psychiatrist is writing prescriptions for medication to help alleviate the anxiety and will check on the
status of the prescription, and be back with the medication as soon as it is available.
Which nursing action is indicated next?
A. Check the client's EMR to see if the medication has been prescribed
B.Wait at least 15 minutes before giving any medication because the client's anxiety may be a short-
lived response to her parents leaving
C. Tell the client to lie down and try to relax until the nurse returns with the medication
D. Ask another nurse to check on the status of the medications prescribed and return - ✔✔D. Ask
another nurse to check on the status of the medications prescribed and return to the client's room and
stay with her
Rationale: Clients experiencing panic should not be left along. Safety concerns exist due to the client's
inability to think clearly. The nurse is more familiar to this client from the assessment intake, and should
be the one to stay with her rather than asking another staff member to do so.
The medication becomes available and the nurse partially opens the packet containing the oral
lorazepam 2 mg. The nurse empties the medication into a paper cup then hands the cup to the client
, with a glass of water. The client refuses to take the cup, and back away from the nurse stating, "I heard
you coughing earlier. I don't want to take it from you."
Which is an indicated response from the nurse in this situation? - ✔✔Empty the pill into the client's
hand without touching the pill.
Rationale: The client has high anxiety, so it is important that she receives medication to help her calm
down. The nurse assuring the client that she will use caution to not touch the pill may help the client
take it and demonstrates an understanding the client's OCD.
The nurse completes an initial nursing intake assessment. When asked what brought her to the hospital,
the client replies, "I can't stop worrying about everything. It's so bad I don't even want to get out of bed
anymore" and she begins to cry. The client admits to having OCD in the past and she had been taking
fluvoxamine for 4 years. She states she weaned herself off the medication 2 months ago because she
was starting college and the medication made her tired. The client states: "I couldn't handle college
though and now I feel like a big failure. I'm just taking up space. I'm no good to anyone."
Which nursing concern should take priority? - ✔✔Potential risk for suicide.
Rationale: Safety should always be the priority and a client is making statements that may indicate risk
for self-directed harm.
The nurse recognizes a need to educate the client on the dangers of stopping her medication without
the supervision of her psychiatrist. The nurse makes a decision to wait until a later time to provide this
education.
Which rationale is the basis for the nurse's decision? - ✔✔The client is currently experiencing severe to
panic levels of anxiety, so education will be ineffective.
Rationale: Clients who are experiencing severe or panic levels of anxiety will have difficulty
concentrating and processing information. Education should be delayed until such a time that a client
can focus.
