A nurse in a mental health clinic is assessing a client who was brought in by her adult daughter. The daughter states that her mother has not been able to leave her home for weeks because she is afraid to be outdoors alone. Which of the following phobias should the nurse anticipate planning care for managing?

Acrophobia

Xenophobia

Agoraphobia

Mysophobia

Answer and Explanation

The Correct Answer is C

Choice A reason: Acrophobia is the fear of heights, which is not indicated by the client's fear of being outdoors alone.

Choice B reason: Xenophobia is the fear of strangers or foreigners, which does not align with the client's described fear.

Choice C reason: Agoraphobia is the fear of open spaces or being in crowded, public places like markets. It also includes the fear of leaving a safe place, such as home, which aligns with the client's symptoms.

Choice D reason: Mysophobia is the fear of germs, which is not related to the fear of being outdoors alone.

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Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Feeling mildly anxious can be a normal reaction after a traumatic event and does not necessarily indicate PTSD.

Choice B reason: Emotional numbing and detachment from others are common symptoms of PTSD, reflecting an avoidance of reminders of the trauma.

Choice C reason: The timeframe of symptoms occurring specifically 2 weeks after the trauma is more indicative of acute stress disorder rather than PTSD.

Choice D reason: Reexperiencing the trauma through dreams or intrusive thoughts is a hallmark symptom of PTSD, often leading to significant distress.

Choice E reason: Hyperarousal, including being on guard and irritable, is a symptom of PTSD that involves an increased state of anxiety and heightened emotional response.

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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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is seeking counseling due to difficulty coping with being a victim of a violent attack 16 months ago. Which elements will the nurse assess for when determining the major components of posttraumatic stress disorder (PTSD)? (Select all that apply.)

Correct Answer is ["B","D","E"]

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

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

The nurse is creating a plan of care for a client with somatic symptom disorder. Which long-term treatment outcomes for this client will be most achievable and measurable? (Select all that apply.)

The nurse observes a lack of hair on the eyebrows and hairline of a young adolescent. Which statement made by the parent demonstrates an understanding of the type of hair loss the child is experiencing?

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

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.)

The nurse is planning the care of a client with bipolar disorder and addiction to heroin who is in a rehabilitation facility. Which outcomes will the nurse assign in the immediate phase after withdrawal symptoms are over? (Select all that apply.)

The nurse is working with another nurse in the emergency department (ED) when a client comes in stating they have been raped during a date. Which statement made by the other nurse privately requires immediate correction?