A client with obsessive-compulsive disorder says, ‘If I do not wash my hands 30 times, my mother will die.’ Anxiety rises when the client tries to delay the ritual. Complete the therapeutic-communication statement.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
The nurse acknowledges the anxiety and invites the client to describe the feared outcome without agreeing that the ritual prevents harm. Within the treatment plan, the nurse supports a collaborative, graded exposure and response-prevention step and coaches coping while anxiety changes. The nurse avoids joining the ritual, repeatedly guaranteeing that the mother is safe, arguing about whether the thought is logical, or abruptly blocking the ritual outside the agreed plan.
Correct Answer Acknowledge the anxiety without validating the feared link, follow the collaborative response-prevention plan, and avoid participating in or repeatedly reassuring the ritual.
Why It Fits Therapeutic communication validates emotion while treatment reduces the compulsive response that maintains the obsession-anxiety cycle.
Clinical Picture The client can participate in a planned graded intervention; sudden coercive blocking is not the same as supported response prevention.
Memory Link Validate the feeling, not the ritual; coach the plan, do not become part of the compulsion.
NCLEX Rule Do not reinforce an obsession by supplying certainty or performing the ritual for the client.
Why the Alternatives Fail Guaranteeing safety becomes reassurance that can feed the cycle. Ridicule and argument damage trust. Unplanned abrupt prevention can sharply increase distress without teaching a coping response.
Source
1NICE OCD and BDD Treatment Recommendations
22026 NCLEX-RN Test Plan
The nurse is working within an interdisciplinary plan that includes cognitive behavioral therapy with exposure and response prevention. The client is not an immediate danger to self or others.
Obsession — A recurrent intrusive thought, image, or urge that causes distress and is difficult to dismiss.
Compulsion — A repetitive behavior or mental act performed to reduce anxiety or prevent a feared event.
Exposure and Response Prevention — A structured therapy that gradually exposes a person to a trigger while supporting the person not to perform the usual compulsion.