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?

Because of the client's cognitive deficits, a signed consent is waived.

Because informed consent is required for ECT, cognitive deficits could preclude this option.

Because the client is extremely suicidal, ECT is an appropriate option.

Because antidepressant medications have been ineffective, ECT is a good alternative.

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is C

Explanation

Choice A reason: Focusing conversations on nutritious food can be positive, but it does not directly indicate a change in behavior related to bulimia nervosa.

Choice B reason: Gaining weight may be a positive sign, but it is not sufficient on its own to indicate a behavioral change, as weight can fluctuate for various reasons.

Choice C reason: Demonstrating healthy coping mechanisms that decrease anxiety is a strong indicator of positive behavioral change in a client with bulimia nervosa, as it suggests the client is developing strategies to manage the disorder.

Choice D reason: While verbalizing an understanding of the disorder's etiology is beneficial, it does not necessarily reflect a change in behavior.

A. "My spouse had a terrible childhood, and I would probably do the same things." B. "If I don't give them money for the drugs, they will just steal it anyway." C. "I told my spouse that in order to be able to come home, they will first have to go to rehab." D. "I am so scared about my spouse getting fired; I often call in sick for them." E. "I can't keep money in the house and have to lock up jewelry in a safe."

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

Explanation

Choice A reason: This statement is an example of rationalizing the spouse's behavior, which can perpetuate the cycle of substance abuse.

Choice B reason: Providing money for drugs, even under the guise of preventing theft, is enabling because it facilitates the continuation of the substance abuse.

Choice C reason: Suggesting rehab as a condition for coming home is not enabling; it is a step towards addressing the substance use disorder.

Choice D reason: Calling in sick on behalf of the spouse to cover for their potential job loss due to substance abuse is an enabling behavior that prevents the spouse from facing the natural consequences of their actions.

Choice E reason: Securing valuables to prevent theft due to the spouse's substance abuse is also enabling because it adjusts normal routines to accommodate the substance use, rather than confronting or addressing the issue.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should the nurse identify as an appropriate indicator of a positive client behavioral change?

Correct Answer is C

Explanation

The nurse is talking with the spouse of a client admitted for substance use disorder and overdose. Which statement(s) made by the spouse indicates that they are exhibiting enabling behaviors? Select all that apply.

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

Explanation

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Which statement(s) made by the spouse indicates that they are exhibiting enabling behaviors? Select all that apply.

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?