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 B

Explanation

Choice A reason: Forgetting people's names can be a symptom of both dementia and delirium, but it is more commonly associated with the progressive cognitive decline seen in dementia.

Choice B reason: Sudden onset of confusion after starting a new medication, such as an antidepressant, is indicative of delirium, which can be triggered by drug interactions or side effects.

Choice C reason: Increased tiredness and sleep could be associated with either condition but are not specific indicators that would distinguish delirium from dementia.

Choice D reason: A loss of interest in previously enjoyed activities is a symptom that can be seen in dementia as part of a gradual decline in engagement and is not specific to delirium.

A. The client will demonstrate alternative ways to deal with stress, anxiety, and other feelings. B. The client will verbally express emotional feelings. C. The client will identify the relationship between stress and physical symptoms. D. The client will learn to vary their schedule. E. The client will assume responsibility for self-care activities.

Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason: Demonstrating alternative ways to deal with stress and anxiety is a measurable outcome, as the client can be observed utilizing different coping strategies in response to stressors.

Choice B reason: The ability to verbally express emotional feelings is an important therapeutic goal for clients with somatic symptom disorder, as it can help them articulate emotions rather than expressing them through physical symptoms.

Choice C reason: Identifying the relationship between stress and physical symptoms is a key component of managing somatic symptom disorder, as it helps the client understand how psychological factors can manifest physically.

Choice D reason: Learning to vary their schedule can help the client avoid routines that may contribute to stress, providing a sense of control and flexibility.

Choice E reason: Assuming responsibility for self-care activities is a significant step towards empowerment and self-management, which is essential for long-term treatment success.

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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

The nurse is performing an assessment for a client brought in by a family member who states they think the client has dementia. When evaluating the assessment data, which finding indicates that the client may likely have delirium and not dementia?

Correct Answer is B

Explanation

The nurse is creating a plan of care for a client with somatic symptom disorder. Which long-term treatment outcomes for this client will be most achievable and measurable? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is preparing to assist with electroconvulsive therapy (ECT). Which of the following pieces of equipment should the nurse set up in the room prior to the treatment? (Select all that apply.)

The nurse is leading a family therapy group with a client addicted to alcohol. Which statement made by the spouse indicates the need for additional education regarding alcoholism as a family illness?

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?

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What is Wernicke-Korsakoff syndrome?

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