A client with a history of major depressive disorder with psychotic features was rescued before jumping off a dam. The client is pacing, picking at the arms, and repeatedly mumbling, "I have to die. You cannot stop me." When the health care provider recommends electroconvulsive therapy (ECT) as the initial treatment, the client’s spouse says to the nurse, "I can’t allow such a cruel treatment. Why can’t they just give my spouse medication?" Which is the best response by the nurse?
"Your spouse could die by not receiving this treatment."
"ECT is safe and your spouse will not feel anything."
"It could take up to 3 weeks for medication to become effective."
"Your spouse is very ill and ECT might be the best treatment at this time. What are your concerns about ECT?"
The Correct Answer is D
Choice A reason: While it is true that untreated suicidal depression can be fatal, this response is confrontational and increases fear without addressing the spouse’s concern.
Choice B reason: Assuring the spouse that the client will not feel anything oversimplifies ECT. Though anesthesia prevents pain, this statement dismisses the spouse’s fears and does not encourage discussion.
Choice C reason: While medications do take weeks to be effective, simply giving this fact does not address the emotional concerns and fears about ECT being “cruel.”
Choice D reason: This response acknowledges the seriousness of the illness, explains why ECT may be necessary, and opens dialogue by inviting the spouse to share concerns. It is therapeutic, informative, and supportive, making it the best choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A reason: Social withdrawal is a negative symptom of schizophrenia, reflecting reduced engagement rather than an excess or distortion of normal function.
Choice B reason: Delusional thinking is a hallmark positive symptom, representing a distortion of reality through fixed false beliefs.
Choice C reason: Bizarre or disorganized behavior, such as unusual movements or incoherent actions, is a positive symptom reflecting disruption in normal functioning.
Choice D reason: Flat affect is a negative symptom, reflecting diminished emotional expression rather than an added or distorted behavior.
Choice E reason: Auditory hallucinations are classic positive symptoms, involving perception of voices or sounds that are not present in reality.
Correct Answer is D
Explanation
Choice A reason: This describes tactile hallucinations, a false sensory experience, not a delusion of reference.
Choice B reason: This reflects a persecutory delusion, where the client believes they are being harmed or targeted, not a delusion of reference.
Choice C reason: This illustrates an auditory hallucination with command-type voices, not a delusion of reference.
Choice D reason: Believing that unrelated environmental cues (like a song) carry special, hidden meaning specifically for the client is the hallmark of a delusion of reference.
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