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
Explanation
Choice A reason: Dismissing the client’s concern as imagination invalidates their feelings and does not uphold honesty, which may worsen paranoia.
Choice B reason: Veracity means truthfulness. Clearly identifying the medication as prescribed treatment provides honest information while supporting trust.
Choice C reason: Withholding information violates both client rights and the ethical principle of veracity. Clients have the right to know what medications they receive.
Choice D reason: Misrepresenting the purpose of the drug undermines trust and is dishonest, which goes against ethical standards.
Correct Answer is A
Explanation
Choice A reason: The nurse’s role is to advocate for the client by collaborating with the healthcare team and ensuring the guardian respects the client’s best interests and personal preferences. This balances autonomy and protection.
Choice B reason: While explaining changes in decision-making is part of education, focusing only on the loss of control without emphasizing advocacy may increase fear and distress.
Choice C reason: Avoiding communication violates therapeutic principles and disregards the client’s dignity. Even if incapable of informed consent, clients should remain included in discussions.
Choice D reason: Treatment cannot proceed without proper consent unless there is an emergency. Acting before guardianship is finalized would violate legal and ethical standards.
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