A nurse is providing teaching to a client who is scheduled for electroconvulsive therapy. Which of the following statements should the nurse include?
"You might experience confusion when first waking up after the procedure."
"You will be given a dose of lorazepam an hour before the procedure."
"This treatment works by stimulating the vagus nerve."
"A special magnet will be placed on your scalp during the procedure."
The Correct Answer is A
Choice A reason: Confusion upon waking is a common and expected side effect of electroconvulsive therapy (ECT). Clients often experience transient disorientation, memory impairment, or headache immediately after the procedure. This occurs because ECT induces a controlled seizure, which temporarily alters brain activity. Nurses must prepare clients for these short-term cognitive effects and reassure them that confusion typically resolves within hours.
Choice B reason: Lorazepam is not administered before ECT because benzodiazepines can raise the seizure threshold and interfere with the therapeutic effect. Instead, clients are given a short-acting anesthetic and a muscle relaxant (commonly methohexital and succinylcholine) to induce unconsciousness and prevent musculoskeletal injury during the seizure. Therefore, this statement is inaccurate.
Choice C reason: ECT does not work by stimulating the vagus nerve. Vagus nerve stimulation (VNS) is a separate treatment modality used for refractory depression and epilepsy. ECT works by inducing a generalized seizure through controlled electrical currents applied to the brain, which alters neurotransmitter activity and improves mood regulation.
Choice D reason: A magnet placed on the scalp is associated with transcranial magnetic stimulation (TMS), not ECT. TMS uses magnetic fields to stimulate specific brain regions without inducing seizures. ECT, in contrast, uses direct electrical currents to trigger a therapeutic seizure. Confusing these modalities can mislead clients, so nurses must clarify the distinction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Fluticasone is an inhaled corticosteroid used for long-term control of asthma. It is not required to be administered before other inhaled medications; bronchodilators are usually given first to open airways before corticosteroids.
Choice B reason: Rinsing the mouth and gargling after each use is correct because inhaled corticosteroids can cause oral candidiasis (thrush). Rinsing removes residual medication and reduces this risk.
Choice C reason: Fluticasone is not used as needed; it is a maintenance medication taken regularly to prevent inflammation. Rescue inhalers such as albuterol are used for acute symptom control.
Choice D reason: Growth may be slowed, not accelerated, in children using inhaled corticosteroids. Monitoring growth is important during long-term therapy.
Correct Answer is A
Explanation
Choice A reason: A flat anterior fontanel indicates adequate hydration. In dehydration, the fontanel becomes sunken, so normalization shows effective treatment.
Choice B reason: Skin turgor displaying tenting is a sign of persistent dehydration, not improvement.
Choice C reason: Hyperpnea (rapid breathing) suggests metabolic acidosis or ongoing fluid imbalance, not resolution.
Choice D reason: Cool, mottled skin indicates poor perfusion and continued dehydration, not effective treatment.
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