Psychiatric Assessment and Fundamentals Q 33
When planning care for a female client using ritualistic behavior, Nurse Gina must recognize that the ritual:
A. Helps the client focus on the inability to deal with reality.
B. Helps the client control the anxiety.
C. Is under the client’s conscious control.
D. Is used by the client primarily for secondary gains.
Correct Answer: B. Helps the client control the anxiety
The rituals used by a client with obsessive-compulsive disorder help control the anxiety level by maintaining a set pattern of action. Obsessive-compulsive disorder (OCD) is often a disabling condition consisting of bothersome intrusive thoughts that elicit a feeling of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ compulsions or rituals. These rituals may be personal and private, or they may involve others to participate; the rituals are to compensate for the ego-dystonic feelings of the obsessional thoughts and can cause a significant decline in function.
Option A: Obsessions are defined as intrusive thoughts or urges that cause significant distress; the patient attempts to neutralize this distress by diverting thoughts or performing rituals. Compulsions are actions the patient feels pressured to do in response to the anxiety/distress producing obsessions or to prevent an uncomfortable situation from occurring. These compulsions may be illogical or excessive.
Option C: The obsessions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The obsessive-compulsive symptoms do not arise from the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Option D: The most common obsessions include fears of contamination, fears of aggression/harm, sexual fears, religious fears, and need to make things “just right.” The compensatory compulsions for these obsessions include washing and cleaning, checking, reassurance-seeking, repeating, and ordering, and arranging.