A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make?

"The most common side effects are directly related to the use of anesthesia."

The main side effects are temporary, and may include mild confusion, a headache, and short-term memory loss."

"Most clients have no adverse effects to this treatment, but muscle cramping may result from the induced seizure."

"Some clients have been known to have a myocardial infarction, but we will monitor your spouse closely to be certain this does not happen."

Answer and Explanation

The Correct Answer is B

A. While anesthesia is used, the side effects from it are not the main concern with ECT.
B. The most common side effects are mild confusion, headache, and short-term memory loss, which are typically temporary.
C. Muscle relaxants are given before the procedure to prevent cramping or injury from the seizure.
D. Myocardial infarction is not a common side effect; this response could unnecessarily alarm the spouse.

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Correct Answer is B

Explanation

A. The patient’s symptoms are physiological and neurological, not intentional behaviors for attention.

B. Alcohol withdrawal delirium (delirium tremens) typically occurs 48–72 hours after the last drink and includes tremors, agitation, anxiety, diaphoresis, tachycardia, hallucinations, and nightmares—all present in this patient.

C. Although head injury can cause confusion and agitation, the timing of symptoms following alcohol withdrawal aligns more closely with delirium tremens.

D. Acute psychosis can present with hallucinations, but in this case, the onset following alcohol cessation and accompanying autonomic hyperactivity point toward alcohol withdrawal delirium.

A. Neuroleptic malignant syndrome B. Dystonia, akinesia, and extrapyramidal symptoms C. Bradycardia and hypotensive episodes D. Sleep disturbances and weight loss

Correct Answer is D

Explanation

A. Neuroleptic malignant syndrome is a rare, life-threatening reaction associated with antipsychotic medications, not stimulants like methylphenidate.

B. Dystonia, akinesia, and extrapyramidal symptoms are primarily seen with antipsychotic use, not with ADHD stimulant medications.

C. Bradycardia and hypotensive episodes – Stimulants more commonly cause tachycardia and hypertension, not bradycardia or hypotension.

D. Sleep disturbances and weight loss are common side effects of methylphenidate due to its stimulant properties. Monitoring sleep patterns, appetite, and growth is a priority in children taking this medication.

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A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make?

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Correct Answer is B

Explanation

What is the nurse's priority focused assessment for side effects in a child taking methylphenidate (Ritalin) for ADHD?

Correct Answer is D

Explanation

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