A client with obsessive-compulsive disorder spends 2 hours each morning checking and rechecking

Question

her home before leaving for work,

then comes home on the lunch hour and spends more than an hour
rechecking faucets, stove burners, appliances, window and door locks, and so forth. The checking
continues after work and during the evening. The client spends so much time in ritualistic behavior
that grooming is poor and social activities are nonexistent. Nursing diagnoses the nurse can
immediately rule out include (more than one answer may be correct)
A. ineffective role performance relative to time spent in rituals.
B. impaired environmental interpretation syndrome relative to confusion.
C. ineffective coping relative to use of compulsive behavior.
D. social isolation relative to excessive use of time to perform rituals.
E. defensive coping relative to feelings of superiority to others.
F. dressing/grooming self-care deficit relative to time spent in rituals.

Answer 1

ANS:
B, E
Rationale: Impaired environmental interpretation syndrome refers to consistent lack of orientation to
person, place, time. Defensive coping is defined as repeated projection of falsely positive
self-evaluation based on a self-protective pattern that defends against underlying perceived threats to
positive self-regard. The other options are relevant to the scenario.