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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Suppression:
Suppression is a psychological defense mechanism where an individual consciously avoids thinking about certain thoughts, emotions, or impulses. It involves intentionally putting aside disturbing or anxiety-inducing thoughts temporarily. People use suppression as a way to cope with overwhelming emotions or stressful situations by delaying dealing with them until they feel more prepared.
B. Regression:
Regression is a defense mechanism where an individual reverts to a previous stage of development in the face of stressful situations. For example, an adult may exhibit childlike behaviors or emotions during times of high stress. This regression is an unconscious way of seeking comfort and security from an earlier, less stressful time in life.
C. Compensation:
Compensation is a defense mechanism in which an individual tries to make up for a perceived deficiency in one area by excelling in another. For instance, someone who feels unattractive might compensate by becoming exceptionally skilled in a particular talent. Compensation involves overachieving in one area to cover up feelings of inadequacy in another.
D. Sublimation:
Sublimation is a defense mechanism where socially unacceptable impulses or urges are channeled into socially acceptable and productive activities. For example, someone with aggressive tendencies might channel their aggression into sports or artistic pursuits. Sublimation involves transforming negative emotions or desires into positive, socially acceptable behaviors.
Correct Answer is D
Explanation
A. Denial:
Denial is a defense mechanism in which a person refuses to accept reality or acknowledge the existence of something that is evident to others. For example, a person diagnosed with a serious illness might deny that they are ill or refuse to believe the diagnosis. In this scenario, the client is not denying a reality; he is expressing anger and directing it toward the nurse.
B. Compensation:
Compensation is a defense mechanism where an individual overachieves in one area to compensate for real or imagined deficiencies in another area. For instance, someone who feels intellectually inferior might excel in sports to compensate for their perceived inadequacy. This is not applicable to the client's situation in the scenario provided.
C. Rationalization:
Rationalization involves providing logical or reasonable explanations to justify behaviors or feelings that might otherwise be unacceptable. For instance, a person might rationalize a failure by blaming external factors rather than accepting personal responsibility. In the scenario, the client is not offering rationalizations but is expressing direct anger.
D. Displacement:
Displacement occurs when emotions, especially anger or frustration, are redirected from the original source to a less threatening target. For example, a person who is angry with their boss might come home and take out their frustration on their family members. In the given situation, the client is displacing his anger from his partner onto the nurse, asking her to leave, making displacement the most appropriate choice.
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