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?

Because of the client's cognitive deficits, a signed consent is waived.

Because informed consent is required for ECT, cognitive deficits could preclude this option.

Because the client is extremely suicidal, ECT is an appropriate option.

Because antidepressant medications have been ineffective, ECT is a good alternative.

Answer and Explanation

The Correct Answer is B

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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Correct Answer is B

Explanation

Choice A reason: Gastric lavage is typically not the first-line treatment for lithium toxicity due to the risk of aspiration and potential complications. It is usually reserved for cases where the ingestion was recent and massive.

Choice B reason: When a client presents with an extremely elevated lithium level, it is crucial to hold further doses to prevent exacerbation of toxicity. The nurse should monitor for early signs of toxicity, which include gastrointestinal symptoms like nausea, vomiting, diarrhea, and neurological symptoms such as tremors, confusion, and ataxia. The normal therapeutic range for lithium is 0.6 to 1.2 mmol/L, and levels above 1.5 mmol/L are considered toxic.

Choice C reason: While it is important to review the medication record, the immediate concern with an extremely elevated lithium level is addressing the toxicity. Checking the medication record can be part of the assessment process but is not the priority action.

Choice D reason: Administering the morning dose of lithium could worsen the client's condition by increasing the lithium level further, which is already extremely elevated. This could lead to severe toxicity or even fatal consequences.

A. Decreased display of emotions. B. Personality traits that are opposite of original traits. C. Decreased auditory and visual acuity. D. Forgetfulness gradually progressing to disorientation.

Correct Answer is D

Explanation

Choice A reason: A decreased display of emotions, or blunted affect, is common in dementia as the illness affects the brain areas responsible for emotion regulation.

Choice B reason: While personality changes can occur, they do not typically present as complete opposites of original traits.

Choice C reason: Decreased auditory and visual acuity can be part of the cognitive decline associated with dementia.

Choice D reason: Forgetfulness that progresses to disorientation is a hallmark of dementia, reflecting the deterioration of cognitive functions over time.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an extremely elevated lithium level. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?

Correct Answer is D

Explanation

The nurse is working with clients with personality disorders that are having problems with relationships and other parts of their life. Which barrier(s) is the nurse experiencing when working with this group of clients? Select all that apply.

A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan?

During an assessment of family dynamics for a client with an eating disorder, which observed issue could indicate a reason for the client's eating disorder?

When engaging with clients, which techniques should the nurse avoid using to foster more therapeutic responses? Select all that apply.

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A client and their spouse come to talk with the nurse about their suspicion that the client may have intermittent explosive disorder after researching it on the internet. Which behaviors reported by the spouse indicate that the client may be experiencing this disorder? (Select all that apply.)

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