A client and their spouse come to talk with the nurse about their suspicion that the client may have intermittent explosive disorder after researching it on the internet. Which behaviors reported by the spouse indicate that the client may be experiencing this disorder? (Select all that apply.)

The explosive episode does not provide a feeling of relief in the client.

The spouse states that the client is mild-mannered and kind unless this occurs.

After having an explosive anger episode, the client was embarrassed and apologetic.

The client punched a hole in the wall and broke furniture during an episode.

The spouse states that the anger arises from something that is not even a big issue.

Answer and Explanation

Correct Answer : B,D,E

Choice A reason: Not feeling relief after an explosive episode can indicate that the behavior is not a controlled release of tension, which is characteristic of intermittent explosive disorder.

Choice B reason: Being mild-mannered and kind does not necessarily indicate intermittent explosive disorder; this behavior could be part of a normal range of personality traits.

Choice C reason: Feeling embarrassed and apologetic after an episode is common in intermittent explosive disorder, as individuals often regret their actions.

Choice D reason: Physical aggression, such as punching walls and breaking furniture, is a key indicator of intermittent explosive disorder.

Choice E reason: Anger that is disproportionate to the situation, especially over minor issues, is a hallmark of intermittent explosive disorder.

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Correct Answer is B

Explanation

Choice A reason:

Informed consent is a critical component of many medical treatments, including ECT. It involves the patient's understanding and agreement to the procedure after being fully informed of the risks, benefits, and alternatives. Cognitive deficits can impair a patient's ability to provide informed consent, but they do not automatically waive the requirement for such consent. In fact, additional safeguards are often put in place to protect the rights of individuals with cognitive impairments.

Choice B reason:

ECT is a medical procedure that requires informed consent due to the potential risks and side effects associated with it. If a client has cognitive deficits severe enough to impact their decision-making capacity, they may not be able to provide informed consent. In such cases, treatment options would need to be reconsidered, and alternative methods of obtaining consent, such as through a legal guardian or a court order, might be necessary.

Choice C reason:

While it is true that ECT is considered an effective treatment for severe depression and suicidality, the decision to use ECT should not be based solely on these criteria². The ability of the client to understand and consent to the treatment is also a crucial factor. Therefore, the extremity of the client's suicidal ideation alone does not make ECT automatically the appropriate option without considering the consent issue.

Choice D reason:

ECT is indeed an alternative treatment when antidepressant medications have been ineffective, especially in cases of severe depression and suicidality². However, the effectiveness of ECT does not negate the need for informed consent. The client's cognitive ability to provide consent remains a determining factor in the feasibility of ECT as a treatment option.

A. Have two nurses present at all times to perform all care and procedures. B. Perform continuous assessment of the client's anxiety level. C. Allow the client to perform all care independently and without assistance. D. Ask for permission before performing any intervention that requires touch. E. Have security present outside of the client's room to prevent anyone from coming in.

Correct Answer is ["B","D"]

Explanation

Choice A reason: Having two nurses present at all times may not be necessary and could be overwhelming for the client, making them feel less in control.

Choice B reason: Continuous assessment of the client's anxiety level is important to ensure that the nurse can respond to the client's needs and maintain a sense of safety.

Choice C reason: While promoting independence is good, the client may need assistance, and providing it can be part of creating a safe environment.

Choice D reason: Asking for permission is crucial as it respects the client's autonomy and helps them feel in control of their body, which is essential for someone who has experienced abuse.

Choice E reason: Having security present outside the room may be excessive and could contribute to a feeling of being guarded or watched, which may not be conducive to feeling safe and secure.

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A client and their spouse come to talk with the nurse about their suspicion that the client may have intermittent explosive disorder after researching it on the internet. Which behaviors reported by the spouse indicate that the client may be experiencing this disorder? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cognitive deficits is extremely suicidal and has not responded to antidepressants. The treatment team is considering electroconvulsive therapy (ECT). Which client information would impact the feasibility of this treatment option?

Correct Answer is B

Explanation

A nurse is caring for a client who has been a victim of abuse since childhood. Which actions by the nurse are important to ensure that the client feels safe, secure, and in control of their own body? Select all that apply.

Correct Answer is ["B","D"]

Explanation

A nurse is caring for a client who has an extremely elevated lithium level. Which of the following actions should the nurse take?

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? Select all that apply.

A client is seeking counseling due to difficulty coping with being a victim of a violent attack 16 months ago. Which elements will the nurse assess for when determining the major components of posttraumatic stress disorder (PTSD)? (Select all that apply.)

The nurse is working to develop a therapeutic nurse-client relationship with a client diagnosed with paranoid personality disorder. Which techniques will the nurse use to foster trust? Select all that apply.

The nurse is planning the care of a client with bipolar disorder and addiction to heroin who is in a rehabilitation facility. Which outcomes will the nurse assign in the immediate phase after withdrawal symptoms are over? (Select all that apply.)

A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response?

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