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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A, administer a fluid bolus.
Choice A rationale:
Administering a fluid bolus is appropriate when a client’s urine output is low, which in this case is less than the minimum expected output of 30 mL/hr. The dark yellow color of the urine also suggests dehydration or concentrated urine, which can be addressed with increased fluid intake.
Choice B rationale:
Initiating continuous bladder irrigation is typically done to clear the urinary tract of blood clots or debris following urologic surgery, not for low urine output or dark urine. Therefore, this intervention is not indicated based on the given scenario.
Choice C rationale:
Obtaining a urine specimen for culture and sensitivity is an action taken when there is a suspicion of a urinary tract infection. The scenario does not provide evidence of infection, such as fever or cloudy urine with a strong odor, so this would not be the first intervention to anticipate.
Choice D rationale:
Clamping the catheter tubing is done in preparation for catheter removal or to assess if the client can void without the catheter. It is not an appropriate intervention for low urine output or dark urine and could potentially cause bladder distention or discomfort.
Correct Answer is D
Explanation
The correct answer is choice D. Administer analgesics on a scheduled basis for the first 24 hr.
This is because the child is at risk for developing peritonitis, which can cause severe abdominal pain.
Scheduled analgesics can provide better pain relief than PRN analgesics.
Choice A is wrong because the child should not be given anything by mouth until bowel sounds return, which can take up to 24 hr after surgery.
Giving clear liquids too soon can cause nausea, vomiting, and abdominal distension.
Choice B is wrong because cromolyn nebulized solution is used to prevent asthma attacks, not to treat appendicitis.
There is no indication that the child has asthma or needs this medication.
Choice C is wrong because applying a warm compress to the operative site can increase inflammation and infection risk.
A cold compress can be used to reduce swelling and pain, but only if prescribed by the provider.
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