# 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. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=525987&lang=en > language: en > subject: Therapeutic Communication > category: PSI ## Question 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. The nurse should respond by ::선택::saying, ‘I can see the thought is causing intense anxiety; tell me what you fear will happen’saying, ‘That makes no sense, so stop washing now’promising that the client's mother cannot be harmedagreeing that another washing cycle will keep the mother safe, then ::선택::abruptly preventing every ritual outside the treatment planfollowing the collaborative graded response-prevention plan and coaching coping skillsperforming the first handwashing steps for the clientchanging the subject whenever the client reports anxiety, while avoiding ::선택::using a calm and neutral toneasking about the client's anxiety levelparticipating in the ritual or repeatedly supplying certaintyreinforcing progress with the agreed treatment step. ## 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. ## In-depth explanation 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 ## Clinical scenario 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. ## Key concepts - **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. ## Related questions - [A client who is breathing rapidly before a diagnostic test says, "I cannot do this. I feel…](https://mymerci.kr/pages/nclex_q.php?qn_id=393566&lang=en) - [A client whose spouse died yesterday says, "I do not know how I can go on." 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