A nurse is evaluating the plan of care for a client diagnosed with obsessive-compulsive disorder (OCD). Which client statement indicates a positive outcome for the plan of care?
A) "Instead of washing my hands several times a day I use hand sanitizer several times a day."
B) "I am still hand washing frequently, and even though it is less than before I am a failure."
C) "I am still hand washing frequently but it is less often than before. I think I am improving."
D) "I don't know why I can't wash my hands several times a day; I have nothing else to do anyway."
Answer: C
The client who acknowledges improvement when washing hands less frequently recognizes that continued obsessive-compulsive behaviors are not an indication of treatment failure and that reductions in behavior signify positive progress. The client who has substituted the ritualistic use of hand sanitizer for the ritualistic hand washing has not demonstrated adequate coping skills to control anxiety related to absence of ritualistic compulsive behaviors. The client who sees nothing wrong with washing hands several times a day does not recognize that the ritualistic hand washing is a problem.
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