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."
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Tell the client, “You seem to be very upset.”.
This is an example of a therapeutic communication technique that validates the client’s feelings and encourages them to express their emotions verbally rather than physically. It also shows empathy and respect for the client’s perspective.
Choice A is wrong because engaging the panic alarm is not the first action to take when interacting with an agitated client.
The nurse should first try to calm the client down by using verbal and nonverbal communication skills, such as maintaining eye contact, speaking in a calm and clear voice, and avoiding sudden movements or gestures.
Engaging the panic alarm should be done only if the client becomes violent or poses a threat to themselves or others.
Choice B is wrong because using a face shield with a mask when providing care to the client is not relevant to the situation.
This is a personal protective equipment (PPE) that is used to prevent exposure to infectious agents or body fluids, not to manage agitation.
Using a face shield with a mask may also increase the client’s anxiety or paranoia, as they may perceive it as a sign of hostility or fear.
Choice D is wrong because initiating seclusion protocol is not appropriate for a client who is agitated, pacing, and speaking loudly.
Seclusion is a restrictive intervention that involves isolating the client in a locked room to prevent harm to themselves or others.
It should be used only as a last resort when less restrictive measures have failed or are contraindicated, and only with a provider’s order and close monitoring.
Secluding an agitated client may escalate their behavior and violate their rights.
Normal ranges for agitation are not applicable, as agitation is not a quantifiable parameter.
However, some tools that can be used to assess agitation include the Richmond AgitationSedation Scale (RASS), which ranges from -5 (unarousable) to +4 (combative), and the Agitated Behavior Scale (ABS), which ranges from 14 (no agitation) to 56 (severe agitation).
Correct Answer is D
No explanation
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