A nurse is caring for a client who has major depressive disorder. After discussing the treatment with his partner, the client verbally agrees to electroconvulsive therapy (ECT) but will not sign the consent form. Which of the following actions should the nurse take?
Request that the client's partner sign the consent form.
Inform the client about the risks of refusing ECT.
Cancel the scheduled ECT procedure.
Proceed with preparation for ECT based on implied consent.
The Correct Answer is C
A. Request that the client's partner sign the consent form:
While involving the client's partner might offer emotional support and facilitate communication, legal and ethical guidelines typically require the informed consent of the individual undergoing the procedure. Having a partner sign the form without the client's explicit consent would not adhere to these standards.
B. Inform the client about the risks of refusing ECT:
Educating the client about the potential risks and benefits of ECT, as well as discussing alternative treatments, is a crucial step in the informed consent process. However, merely informing the client does not replace the need for the client to provide explicit, written consent for the procedure to be performed legally and ethically.
C. Cancel the scheduled ECT procedure:
This is the correct action. Without the client's signed consent, the procedure cannot proceed. Canceling the ECT procedure respects the client's autonomy and adheres to legal and ethical standards surrounding informed consent. The healthcare team should continue to engage with the client, addressing any concerns and questions, to obtain their informed and voluntary consent before rescheduling the procedure if the client chooses to proceed.
D. Proceed with preparation for ECT based on implied consent:
Implied consent is not sufficient for significant medical procedures such as ECT. Implied consent implies agreement based on actions or behavior rather than explicit, informed agreement. For procedures like ECT, it is essential to have documented, explicit, and voluntary consent from the client before proceeding. Relying solely on implied consent would not meet the ethical and legal requirements for informed consent.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Reassure staff members that the debriefing is confidential:
Explanation: This step is crucial in establishing trust among the participants. Reassuring confidentiality encourages individuals to express their feelings and experiences openly. It helps create a safe environment where people can share their emotions without fear of judgment or repercussions.
B. Have staff members discuss their involvement in the event:
Explanation: After establishing confidentiality, it might be appropriate to encourage participants to discuss their involvement in the event. This allows individuals to share their perspectives and experiences, helping others understand the situation from different angles. Sharing experiences can provide insights into how different people were affected and how they coped.
C. Ask staff members to describe their most traumatic memories of the event:
Explanation: While it might be a natural inclination to immediately delve into the most traumatic memories, it's generally not the first step in a critical incident stress debriefing. Encouraging participants to share their most traumatic memories right away could be overwhelming and retraumatizing. The process usually begins with establishing trust and then progresses to discussing individual experiences, gradually leading to more specific and potentially distressing details.
D. Provide stress-management exercises to the staff members:
Explanation: Stress-management exercises are valuable and often an essential part of the debriefing process. However, introducing stress-management techniques usually comes after participants have had the opportunity to express their feelings and experiences. These exercises can include relaxation techniques, breathing exercises, or mindfulness practices, which help individuals manage their stress and anxiety effectively.
Correct Answer is B
Explanation
A. Clients who are involuntarily committed do not maintain access to legal counsel.
This statement is incorrect. Clients who are involuntarily committed generally do have the right to legal counsel. They can challenge their commitment in a court of law, and legal representation is often provided to them if they cannot afford it.
B. Clients must be informed of the risks of treatment.
This statement is correct. Informed consent is a fundamental principle in healthcare, including mental health treatment. Clients have the right to be fully informed about the risks and benefits of any treatment or procedure before giving consent.
C. Clients who have a severe mental illness cannot request a psychiatric advance directive.
This statement is incorrect. Clients with severe mental illness can, and should, create psychiatric advance directives. These directives allow individuals to specify their preferences regarding mental health treatment in advance, ensuring their wishes are respected even if they are not able to communicate them at a later time due to their mental condition.
D. Clients who are violent can refuse chemical restraint.
This statement is generally incorrect. In emergency situations where a client poses an immediate danger to themselves or others, chemical restraint might be administered without the client's consent to ensure safety. However, there are strict guidelines and regulations surrounding the use of chemical restraints, and they should only be used in specific situations and as a last resort. In non-emergency situations, clients generally have the right to refuse any treatment, including chemical restraint, unless it is court-ordered due to their condition posing an imminent risk.
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