A nurse is contributing to the plan of care for a client who has obsessive-compulsive disorder regarding brushing his teeth. The client brushes his tongue several times a day and has developed several ulcerations. Which of the following interventions should the nurse identify as a priority?

Choice A reason: Speaking calmly and soothingly is supportive but not the priority. While therapeutic communication is important, it does not directly address the physical harm the client is experiencing from repetitive brushing. Choice B reason: Identifying triggers to obsessive behaviors is useful for long-term management, but it is not the immediate priority. The client already has ulcerations, so the nurse must first address the underlying anxiety driving the compulsive behavior. Choice C reason: Assisting the client in identifying his anxiety level is the priority because compulsive behaviors are driven by attempts to reduce anxiety. By helping the client recognize when anxiety is escalating, the nurse empowers him to intervene before engaging in harmful compulsions. This approach directly addresses the root cause of the behavior and prevents further physical injury. Choice D reason: Providing information on stress reduction methods is beneficial but secondary. Stress reduction techniques are part of long-term management, but they do not immediately address the client’s awareness of his anxiety or the physical harm caused by compulsive brushing.