OCD - test question

number41 · Mar 10, 2012

ooh, that's interesting lol. my initial reaction is C, because eliminating ritualistic behavior is not short term. while it's achievable, it is a process. limiting handwashing is the same as decreasing number of times she washes her hands and again, are not quickly achieved. while they can be goals, and should be, I would think the primary goal would be to help take care of the the result of the behavior (providing good skin care). you wouldn't ignore the fact that she's probably scrubbed her hands until they're raw, until she is able to eliminate this ritual. I don't know, just my two cents but I can't say for sure :) good luck!

Clovery · Mar 10, 2012

I did choose C, with the same reasoning. I'm worried it could have been A (to decrease handwashing), especially since C is really poorly worded (yes, it said that exactly) "provide good skin care" is kind of vague. What really confused me is that usually the patients have goals/outcomes and the nurses have interventions, and it wasn't specified short term or long term. If it said long term then I think I would have picked D - eliminate. In the short term for OCD you're initially supposed to allow plenty of time for their rituals. Ugh, who knows. Thanks for your reply, hopefully we are right.

On a happier note - yay spring break!

nurseprnRN, BSN, RN · Mar 10, 2012

a. decrease the number of times she washes her hands

b. limit the handwashing

c. provide good skin care

d. eliminate the ritualistic behavior

skin care is a good idea and you'd do it because it's a safety thing. it is also the only thing on the list that is solely within nursing's purview. in my opinion it's not actually a goal, though your faculty may see it differently.

all of the other three are basically saying the same thing. one could make a case that nursing might be developing tactics to distract her and limit her handwashing/decrease the # of times she does it, but since those two are identical, probably one of those is not the answer. eliminating the ritualistic behavior is going to depend on the medical plan of care as much as the nursing plan of care.

so what did they say?

Clovery · Mar 10, 2012

I won't know the answer until the 19th or 20th. We started spring break and my instructor isn't going to post the scores until after. Then I'll have to go to her office hours to look at my exam to see which ones I got wrong.

This test was really difficult. I was answering NCLEX and study guide questions with 100% accuracy on the topics and I'm pretty sure I could write everything we needed to know into an awesome essay. But then I got this test yesterday and so many questions made me go "what the heck does she mean here?" They seemed intentionally tricky.

I'll bump this when I get the answer, for those who are curious.

diligent-trooper · Mar 10, 2012

I agree... © Good skin care. You will notice the other three listed answers are similar. Answer © is way different; therefore, the answer. Violia!

psu_213, BSN, RN · Mar 10, 2012

I agree... © Good skin care. You will notice the other three listed answers are similar. Answer © is way different; therefore, the answer. Violia!

My initial thinking was long those lines as well. As I looked at the question again, the word 'goal' stands out. My psych instructor would say something to the effect of "well, that is an intervention, not a goal for the pt."

The problem is that A, B, and D are all basically the same. If I really had to nit pick the question/choices apart...D seems a bit unreasonable for an initial goal. B, again, it is more of an intervention than a goal: you (the nurse) are doing something, not setting a goal for the pt.

That leaves us with A. With a bit more fine tuning that would be a reasonable goal. "Pt will decrease the number times she washes her hands from 30 per day to 15 per day by the end of the week." So, as written, this is not a careplan goal, but this is the best goal of the choices provided.

number41 · Mar 18, 2012

Did you find out yet?

Clovery · Mar 20, 2012

I found out I got a 94 (3 wrong) but the score was just posted online and I have to go to office hours tomorrow to review my exam. I'm planning on going to see what I got wrong so I will definitely post the answer tomorrow evening :)

number41 · Mar 20, 2012

Awesome congrats!!

Clovery · Mar 21, 2012

Awesome congrats!!

thanks!

the answer was A - decrease the handwashing.

my instructor said you would provide skin care, but the first goal would be to decrease the handwashing. thanks to everyone who replied.