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A nurse is caring for a client who has given informed consent for electroconvulsive therapy (ECT). Just before the procedure, the client expresses to the nurse that she is having second thoughts and is considering not going through with the treatment. What is the most appropriate response for the nurse in this situation?

"It's understandable to feel nervous before this treatment. Most people feel better after, but you have the right to change your mind at any time."

"I know this is a difficult decision, but the doctor believes ECT is the best option for you. Are you sure you want to cancel?"

"That's completely fine! We can reschedule for another time when you're feeling more ready."

"You signed the consent form, so you need to go through with the treatment. It's important to follow through on your commitments."

Answer and Explanation

The Correct Answer is A

The correct answer is Choice A.

Choice A rationale:

Acknowledges the client's feelings: It's important for the nurse to validate the client's concerns and let them know that it's understandable to feel nervous or uncertain about ECT.
Provides information about the treatment: The nurse can offer information about the potential benefits of ECT, but it's important not to pressure the client or make them feel like they have to go through with it.
Reassures the client of their right to change their mind: This is a crucial aspect of informed consent. The client has the right to withdraw their consent at any time, even after signing the consent form.

Choice B rationale:

Places undue pressure on the client: This response implies that the doctor knows what's best for the client and that the client should go through with the treatment even if they have doubts. This can undermine the client's autonomy and decision-making ability.

Choice C rationale:

May minimize the client's concerns: While rescheduling the treatment is an option, it's important to explore the client's concerns more thoroughly before suggesting this. It's possible that the client has valid reasons for not wanting to go through with ECT, and these reasons should be addressed.

Choice D rationale:

Is disrespectful of the client's autonomy: This response suggests that the client is obligated to go through with the treatment simply because they signed a consent form. This ignores the fact that people can change their minds and that consent is an ongoing process.

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Free Nursing Study Resources

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

Explanation

A, B, C, D, and H. Here is why:.

A. Heart rate: The client’s heart rate is elevated at 118/min, which could indicate blood loss, dehydration, pain, anxiety, or infection. This finding requires immediate follow-up to assess the cause and intervene as needed.
B. Current medications: The client is taking ibuprofen 800 mg three times daily PRN for arthritis pain. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastric irritation, ulceration, and bleeding. This finding requires immediate follow-up to evaluate the client’s pain level, medication use, and possible alternatives to NSAIDs.
C. Blood pressure: The client’s blood pressure is low at 90/50 mm Hg, which could indicate hypovolemia, shock, or cardiac dysfunction. This finding requires immediate follow-up to monitor the client’s fluid status, perfusion, and organ function.
D. Stool results: The client’s stool tested positive for occult blood and H. pylori bacteria. Occult blood indicates gastrointestinal bleeding, which could be related to the client’s abdominal pain and weight loss. H. pylori is a common cause of peptic ulcer disease, which can also cause bleeding and pain. This finding requires immediate follow-up to confirm the diagnosis and initiate treatment with antibiotics and acid-suppressing drugs.

H. Hemoglobin and hematocrit: The client’s hemoglobin and hematocrit are low at 9.1 g/dL and 27%, respectively. These values indicate anemia, which could be caused by chronic blood loss, nutritional deficiency, or bone marrow suppression. This finding requires immediate follow-up to determine the etiology and severity of the anemia and provide appropriate therapy such as blood transfusion, iron supplementation, or erythropoietin.

The other findings are not as urgent as the ones above:.

E. Respiratory rate: The client’s respiratory rate is normal at 18/min. There is no evidence of respiratory distress or hypoxia.
F. WBC count: The client’s WBC count is normal at 6,700/mm3. There is no indication of infection or inflammation.
G. Temperature: The client’s temperature is slightly elevated at 37.5° C (99.5° F), but not enough to warrant immediate concern. It could be due to stress, dehydration, or a mild infection. The nurse should monitor the temperature trend and report any significant changes or signs of sepsis.

A. Naproxen sodium. B. Ibuprofen. C. Acetaminophen. D. Aspirin. E. undefined

Correct Answer is C

Explanation

Enoxaparin is a blood thinner that helps prevent the formation of blood clots in people who have certain medical conditions or who are undergoing certain procedures. Enoxaparin can increase the risk of bleeding, especially if taken with other medications that affect blood clotting, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin.

Therefore, the nurse should instruct the client to avoid taking pain relievers such as naproxen sodium (choice A), ibuprofen (choice B), or aspirin (choice D) while on enoxaparin. These pain relievers can make the client more likely to bleed when on enoxaparin. Acetaminophen (choice C) is a pain reliever that does not affect blood clotting and can be taken safely with enoxaparin. However, the client should follow the directions on the box to make sure they do not take more than the recommended amount of acetaminophen, as it can cause liver damage in high doses.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is admitted to the medical-surgical unit. Client reports, "I'm bloated and my stomach hurts." Exhibits The nurse reviews the client's laboratory findings and vital signs. Select the 5 findings that require immediate follow-up.

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

Explanation

A nurse is providing teaching to a client who has a new prescription for enoxaparin. Which of the following medications for pain relief should the nurse include in the teaching that can be taken concurrently with enoxaparin?

Correct Answer is C

Explanation

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