A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive therapy (ECT). The client refuses the treatment and will not discuss why with the health care team. Which of the following actions should the nurse take?
Tell the client he cannot refuse the treatment because he was involuntarily committed.
Ask the client's family to encourage the client to receive ECT.
Document the client's refusal of the treatment in the medical record.
Inform the client that ECT does not require client consent.
The Correct Answer is C
A. Coercing the client into treatment violates the client's autonomy and rights. Involuntary commitment does not mean the client loses the right to refuse treatment.
B. Involving the client's family without their consent or participation in decision-making may not be appropriate and could breach confidentiality.
C. Documenting the client's refusal of treatment ensures that the decision is appropriately recorded in the medical record and facilitates communication among the healthcare team members. It also protects the client's autonomy and legal rights.
D. Informing the client that ECT does not require consent is incorrect. While laws regarding involuntary treatment vary by jurisdiction, clients generally have the right to refuse treatment, even if they are involuntarily committed.
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Related Questions
Correct Answer is D
Explanation
A. Jaundice is not a commonly reported adverse effect of citalopram. It is more commonly associated with liver dysfunction or other medications.
B. Urinary retention is not a commonly reported adverse effect of citalopram. It is more commonly associated with anticholinergic medications.
C. Bruising is not a commonly reported adverse effect of citalopram. It is more commonly associated with medications that affect platelet function or clotting factors.
D. Decreased libido (reduced sexual desire) is a potential adverse effect of citalopram, as it is with other selective serotonin reuptake inhibitors (SSRIs). Monitoring for changes in sexual function is important because it can affect quality of life and treatment adherence.
Correct Answer is A
Explanation
A. Encouraging physical activity during the day has been shown to improve mood and reduce symptoms of depression by increasing endorphin levels and promoting a sense of well-being.

B. Identifying and scheduling alternative group activities for the client may be helpful in reducing social isolation and improving mood but should not replace physical activity.
C. Discouraging the client from expressing feelings of anger is not appropriate, as it may suppress emotions and hinder therapeutic communication. Instead, the nurse should encourage the client to express and explore their emotions in a healthy manner.
D. Keeping a bright light on in the client's room at night may disrupt sleep patterns and exacerbate symptoms of depression, as individuals with depression often have disturbances in their sleep-wake cycle.
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