00:01
The nurses caring for a client
admitted with a diagnosis of
obsessive-compulsive
personality disorder.
00:07
Which behavior most
concerns the nurse.
00:11
All right,
this is a short and succinct one.
00:13
But it's got a lot
going on in that stem.
00:16
I'm a nurse, caring for a
client who's been admitted.
00:20
All right.
So we know that this patient
is not able to function
at home safely right now.
00:24
So I'm caring for a client
who's been admitted.
00:27
The diagnosis is
obsessive-compulsive
personality disorder.
00:32
So I think back in my mind,
anytime I see a diagnosis,
what are the challenges
the problems with that?
I'll remember,
there's these rituals involved
with obsessive-compulsive disorder.
00:41
You think you have to keep going
through this entire ritual,
or something bad
is going to happen.
00:48
Well, do you know
what the bad thing is?
Sometimes they do.
Sometimes they don't.
00:53
But they just know
the way their mind is working,
that if they don't go
through their rituals,
something really bad
is going to happen.
01:00
Which is why they obsess
and feel like they can't choose
to stop doing it.
01:05
Now, the last part, that second
sentence that focuses the question,
what we're looking for,
it says which behavior
most concerned the nurse?
All right,
why did I say it like...?
Because look at that word,
it's telling you right there.
01:22
Even on the NCLEX.
01:23
That type of word will be bolded.
01:26
So it should jump
off the page at you.
01:28
That means,
you're going to have to prioritize.
01:32
Now this question will likely
have more than one correct answer.
01:37
Ooo, I know you don't like that.
01:39
But that's how the game is played.
01:41
So we're looking
for most concerning
about this patient with obsessive
compulsive personality disorder.
01:49
What's the most
concerning behavior?
Now, let's bring in
the answer choices.
01:56
Okay,
you've got four options there.
02:00
Now, I want you to pause the video,
work through these four
options on your own.
02:05
Have the numbers
1, 2, 3, and 4 numbers only.
02:09
Written on
your practice sheet.
02:11
Now pause it.
02:12
And I want you to work
through these answer choices
asking yourself that
topic of that question.
02:18
Which behavior is most
concerning to the nurse
for a client who has obsessive
compulsive personality disorder?
Ready? I'll see you
back in a few minutes.
02:28
Please take your time.
02:29
Take all the time you need to do
your very best on this question.
02:41
Welcome back.
02:43
All right,
we've got four behaviors.
02:45
So we know that we're gonna
have to eliminate three
and end up with one correct
or most correct answer.
02:54
So let's see.
02:55
The topic of the question is OCD.
02:58
Number one,
cleaning the room constantly.
03:02
Is Adeline with OCD?
Yes.
03:05
Without sleeping in
the past two days.
03:08
Whoa, okay, not getting rest.
That's a problem.
03:11
So for now,
I'm gonna leave that one in.
03:14
I am not ready to cross it off.
03:16
Number two.
03:18
Hand washing after touching
every surface and after handshakes.
03:24
Does that line up with
obsessive compulsive?
Yes, it sure does.
03:30
Now, let me compare
it to number one,
because I hadn't
eliminated that yet.
03:34
So it was hand washing
after touching every surface
and after handshakes
worse than
cleaning the room constantly
without sleeping
in the past two days.
03:44
Which one of those behaviors is a
bigger risk to the patient's safety?
Because all questions are about
keeping particular patients
in particular settings, the safest.
03:55
So Nope. Number one is worse.
03:58
It's a bigger risk to
the patient's safety,
because they're not sleeping
for the past two days.
04:04
So number two, I know that you will
line up with obssesive compulsive,
but it's not as dangerous
to the patient as number one.
04:11
Now number three.
04:13
Going back to the room
three or four times
to make sure the doors are closed.
04:18
I kind of do this
when I leave the house.
04:20
That always pops up like,
"Ooh, did I close that?
Did I turn that off?"
So those thoughts can be come
kind of locked in your brain"
And that does line up with
someone who would be admitted
with this personality disorder.
04:33
However,
is it worse than number one?
Is it a bigger risk
to the patient's safety?
Is number three a bigger risk
to patient safety or number one?
Nope, it's still number one.
04:45
Because they're not sleeping.
04:47
That's a bigger risk
to the patient safety.
04:49
And then just going back and forth
to the room three or four times
to make sure the doors are closed.
04:54
All right, so we're down to
number one and number four.
04:57
Feeling sad and hopeless
about getting into college.
05:02
All right. That's not a
real pleasant thing. Right?
That can be anxiety.
That might be depression.
05:10
But are we more at risk
there for a client
with obsessive compulsive disorder?
You may be tempted
to pick number four.
05:18
But really the answer is,
number one.
05:22
Why? Number four doesn't give us
any indication that the patient
is going to harm themselves.
05:27
They're just feeling
sad and hopeless.
05:30
Patients can experience
these feelings
and not be intending
to harm themselves.
05:35
But number one,
we know in the here, in the now
is a significant problem.
05:41
And that's why that one
most concerns the nurse.
05:46
All right, it's time to reflect
on how you did.
05:49
Now, I know sometimes
mental health questions
are really frustrating
to a lot of students.
05:54
But I promise you as you slow
down and start practicing,
you're going to pick
up some patterns.
06:00
Sometimes when you see
sad or feeling hopeless,
you want to go boom,
right to that's the person
we need to follow up.
06:06
But remember,
look at the topic of the question.
06:09
And keep in mind,
don't assume something.
06:13
Don't assume that they're
going to harm themselves.
06:16
And we're comparing
number four, to number three,
to number two, to number one.
06:21
So this isn't always a wrong answer.
It's not always a right answer.
06:27
It's always a relative process.
You're looking for the top priority.
06:32
So in this case, it was number one.
06:35
Now what do you need
to write in your notebook?
What do you need to remember?
What can you take
from this question
that you can apply
to other questions?
Now,
let's go on to another question.