A nurse is caring for a client who has major depressive disorder. After discussing the treatment with his partner, the client verbally agrees to electroconvulsive therapy (ECT) but will not sign the consent form. Which of the following actions should the nurse take?
Request that the client's partner sign the consent form.
Inform the client about the risks of refusing ECT.
Cancel the scheduled ECT procedure.
Proceed with preparation for ECT based on implied consent.
The Correct Answer is C
A. Request that the client's partner sign the consent form:
While involving the client's partner might offer emotional support and facilitate communication, legal and ethical guidelines typically require the informed consent of the individual undergoing the procedure. Having a partner sign the form without the client's explicit consent would not adhere to these standards.
B. Inform the client about the risks of refusing ECT:
Educating the client about the potential risks and benefits of ECT, as well as discussing alternative treatments, is a crucial step in the informed consent process. However, merely informing the client does not replace the need for the client to provide explicit, written consent for the procedure to be performed legally and ethically.
C. Cancel the scheduled ECT procedure:
This is the correct action. Without the client's signed consent, the procedure cannot proceed. Canceling the ECT procedure respects the client's autonomy and adheres to legal and ethical standards surrounding informed consent. The healthcare team should continue to engage with the client, addressing any concerns and questions, to obtain their informed and voluntary consent before rescheduling the procedure if the client chooses to proceed.
D. Proceed with preparation for ECT based on implied consent:
Implied consent is not sufficient for significant medical procedures such as ECT. Implied consent implies agreement based on actions or behavior rather than explicit, informed agreement. For procedures like ECT, it is essential to have documented, explicit, and voluntary consent from the client before proceeding. Relying solely on implied consent would not meet the ethical and legal requirements for informed consent.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Respect the client's need for social isolation:
While it's important to respect the client's need for moments of solitude and privacy, complete social isolation can lead to feelings of loneliness and exacerbate depressive symptoms. Balance is key; the nurse should encourage social interactions and support while respecting the client's need for personal space and alone time.
B. Encourage the client's family members to perform the client's ADLs:
Encouraging the client's family members to take over all activities of daily living (ADLs) can strip the client of their independence and self-efficacy. Instead, the nurse should support the client in actively participating in their self-care activities to the extent they are able. This promotes a sense of control and empowerment during a challenging time.
C. Discourage the client from talking about activities he did prior to the amputation:
Discouraging the client from discussing their life before the amputation can hinder the process of accepting the loss. Allowing the client to talk about their past experiences, activities, and memories can be therapeutic. It helps them process the grief associated with the amputation and allows for a healthy expression of emotions.
D. Determine the client's stage of grief:
Understanding the client's stage of grief is crucial. Grieving is a natural and individual process, and different people progress through stages like denial, anger, bargaining, depression, and acceptance at their own pace. By identifying the client's current stage of grief, the nurse can offer tailored support and interventions, ensuring the client's emotional needs are met effectively.
Correct Answer is A
Explanation
A. "Reassure staff members that the debriefing is confidential."
This is an appropriate first step. Ensuring confidentiality creates a safe environment where individuals feel comfortable sharing their experiences and emotions.
B. "Have staff members discuss their involvement in the event."
This can be a part of the debriefing process, but it might not be the first step. Generally, individuals are given the option to share their experiences, but they should not be forced to do so. Some might not be ready to talk about their involvement immediately.
C. "Ask staff members to describe their most traumatic memories of the event."
This might be too intrusive as a first step. It's important to approach discussions about specific traumatic memories with caution and only when individuals are comfortable sharing.
D. "Provide stress-management exercises to the staff members."
This could be a helpful step after ensuring confidentiality and allowing individuals the opportunity to express their feelings. Stress-management exercises can provide valuable coping strategies.
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