The nurse is leading a family therapy group with a client addicted to alcohol. Which statement made by the spouse indicates the need for additional education regarding alcoholism as a family illness?

"We have separated our finances so that I will not go broke."

"I take my kids with me to Al-Anon meetings every week."

"Last time the client got arrested, I just let the client sit in jail."

"I have to call in sick for the client when the client is too hungover to go to work."

Answer and Explanation

The Correct Answer is D

Choice A reason: Separating finances is a practical step but does not address the underlying issues of alcoholism as a family illness.

Choice B reason: Attending Al-Anon meetings is a positive step towards understanding and coping with the effects of a family member's alcoholism.

Choice C reason: Allowing the client to face the consequences of their actions can be part of setting boundaries, which is important in dealing with alcoholism.

Choice D reason: Calling in sick for the client enables the behavior and prevents the client from facing the natural consequences of their alcoholism, indicating a need for further education on the illness.

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Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason: While it’s important to assess access to lethal means, this question is too specific and assumes the client owns a gun. A more appropriate question might be, “Do you have access to any means to harm yourself?”

Choice B reason: Inquiring about thoughts of self-harm or harming others is a direct question that assesses suicidal ideation and intent, which is essential for determining immediate risk.

Choice C reason: Understanding if the client has specific plans for self-harm can help gauge the immediacy and seriousness of the suicide risk.

Choice D reason: Discussing feelings about dying can provide insight into the client's emotional state and potential risk for suicide.

Choice E reason: This question is important but it should not replace direct questions about the client’s current thoughts and feelings. It’s possible for a client to deny feelings of suicidality to their psychiatrist while still experiencing them.

A. Because of the client's cognitive deficits, a signed consent is waived. B. Because informed consent is required for ECT, cognitive deficits could preclude this option. C. Because the client is extremely suicidal, ECT is an appropriate option. D. Because antidepressant medications have been ineffective, ECT is a good alternative.

Correct Answer is B

Explanation

Choice A reason:

Informed consent is a critical component of many medical treatments, including ECT. It involves the patient's understanding and agreement to the procedure after being fully informed of the risks, benefits, and alternatives. Cognitive deficits can impair a patient's ability to provide informed consent, but they do not automatically waive the requirement for such consent. In fact, additional safeguards are often put in place to protect the rights of individuals with cognitive impairments.

Choice B reason:

ECT is a medical procedure that requires informed consent due to the potential risks and side effects associated with it. If a client has cognitive deficits severe enough to impact their decision-making capacity, they may not be able to provide informed consent. In such cases, treatment options would need to be reconsidered, and alternative methods of obtaining consent, such as through a legal guardian or a court order, might be necessary.

Choice C reason:

While it is true that ECT is considered an effective treatment for severe depression and suicidality, the decision to use ECT should not be based solely on these criteria². The ability of the client to understand and consent to the treatment is also a crucial factor. Therefore, the extremity of the client's suicidal ideation alone does not make ECT automatically the appropriate option without considering the consent issue.

Choice D reason:

ECT is indeed an alternative treatment when antidepressant medications have been ineffective, especially in cases of severe depression and suicidality². However, the effectiveness of ECT does not negate the need for informed consent. The client's cognitive ability to provide consent remains a determining factor in the feasibility of ECT as a treatment option.

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The nurse is leading a family therapy group with a client addicted to alcohol. Which statement made by the spouse indicates the need for additional education regarding alcoholism as a family illness?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse should frequently assess a client with a depressive disorder for lethality risk related to suicidal ideation. Which questions should the nurse include? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

A client with cognitive deficits is extremely suicidal and has not responded to antidepressants. The treatment team is considering electroconvulsive therapy (ECT). Which client information would impact the feasibility of this treatment option?

Correct Answer is B

Explanation

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