a nurse is planning care for a client with obsessive compulsive disorder ocd which intervention should be included in the care plan
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ATI RN

ATI Mental Health Proctored Exam 2019

1. A client is being treated for obsessive-compulsive disorder (OCD). Which intervention should be included in the care plan?

Correct answer: B

Rationale: Allowing the client to perform rituals in the early stages of treatment is a common therapeutic approach for obsessive-compulsive disorder (OCD). Allowing the client to engage in rituals can help reduce anxiety by providing temporary relief. It is a part of exposure therapy, where the individual is gradually exposed to anxiety-provoking situations. As treatment progresses, the focus shifts to gradually reducing the frequency and intensity of rituals through interventions like exposure and response prevention therapy. Discouraging the client from performing rituals (Choice A) is not recommended as it may increase anxiety and resistance to treatment. Encouraging the client to focus on their compulsions (Choice C) may reinforce the behavior rather than helping to decrease it. Isolating the client (Choice D) is not therapeutic and can lead to feelings of abandonment and worsen symptoms.

2. A client with post-traumatic stress disorder (PTSD) is experiencing flashbacks. Which of the following interventions should the nurse implement?

Correct answer: B

Rationale: During a flashback, it is essential for the nurse to stay with the client and offer reassurance. This approach can help the client feel safe and supported during a distressing experience. Encouraging the client to ignore the flashbacks may lead to increased anxiety and distress. Instructing the client to avoid discussing the traumatic event can hinder the therapeutic process of addressing and processing the trauma. While group therapy can be beneficial, it may not be the immediate intervention needed during a flashback.

3. Which client action is an example of the defense mechanism of reaction formation?

Correct answer: A

Rationale: The defense mechanism of reaction formation involves expressing the opposite of one's true feelings. In this case, the woman who feels unattractive praises the looks of others as a way to mask her own feelings of inadequacy. This behavior represents a form of overcompensation where the individual showcases an exaggerated opposite trait to conceal their true emotions. Choices B, C, and D do not align with reaction formation. Choice B describes compensation, where one overemphasizes a trait to make up for a perceived weakness. Choice C illustrates projection, where one attributes their feelings onto others. Choice D demonstrates a form of seeking attention or approval, which does not fit reaction formation.

4. A patient presents in the Emergency Department immediately following a shooting incident in a school where she has been teaching. There is no evidence of physical injury, but she appears very hyperactive and talkative. Which of these symptoms manifested by the patient is an uncommon initial biological response to stress?

Correct answer: A

Rationale: Increased lacrimal secretions, palpitations, and increased heart rate are common initial biological responses to stress. Constricted pupils are not typical in the initial response to stress and are more associated with the opposite response, the Rest and Digest system. Watery eyes, palpitations, and increased heart rate are indicative of the body's fight or flight response to stress. Unusual food cravings are not a typical biological response to stress.

5. While assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons, how should the nurse interpret the student's reaction to her perceived problem?

Correct answer: B

Rationale: In this scenario, the student being overly concerned about not being able to afford horseback riding lessons indicates that the problem is personally relevant to her. Psychological stressors related to self-esteem and self-image are influenced by how an individual perceives a situation or event. Adolescents, in particular, place significance on self-image and feeling entitled to experiences that other adolescents have, which can lead to distress when such desires are not met. Choice A is incorrect because there is no indication that the student's physical well-being is at risk. Choice C is incorrect as it simplifies the issue by attributing it solely to immaturity. Choice D is incorrect as there is no evidence provided that the problem is beyond the student's coping abilities.

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