A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive therapy (ECT). The client refuses the treatment and will not discuss why with the health care team. Which of the following actions should the nurse take?

Tell the client he cannot refuse the treatment because he was involuntarily committed.

Ask the client's family to encourage the client to receive ECT.

Document the client's refusal of the treatment in the medical record.

Inform the client that ECT does not require client consent.

Answer and Explanation

The Correct Answer is C

A.   Coercing the client into treatment violates the client's autonomy and rights. Involuntary commitment does not mean the client loses the right to refuse treatment.
B.   Involving the client's family without their consent or participation in decision-making may not be appropriate and could breach confidentiality.
C.   Documenting the client's refusal of treatment ensures that the decision is appropriately recorded in the medical record and facilitates communication among the healthcare team members. It also protects the client's autonomy and legal rights.
D.   Informing the client that ECT does not require consent is incorrect. While laws regarding involuntary treatment vary by jurisdiction, clients generally have the right to refuse treatment, even if they are involuntarily committed.

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Correct Answer is A

Explanation

A. Displacement involves redirecting emotions or behaviors from the original source to a less threatening or more accessible target. In this scenario, the client is redirecting his anger from his partner to the nurse, who is perceived as a safer target.
B. Compensation involves overachieving in one area to compensate for deficiencies in another area and is not demonstrated in this scenario.
C. Denial involves refusing to acknowledge the existence of a real situation or the feelings associated with it, which is not evident in the client's behavior.
D. Rationalization involves creating logical or socially acceptable explanations for behaviors or feelings that are unacceptable, which is not demonstrated in the client's behavior in this scenario.

A. Writes a detailed daily activity schedule B. Isolates self from others C. Reports a lack of sleep D. Refuses to engage in conversation

Correct Answer is C

Explanation

A. Writing a detailed daily activity schedule may indicate organization and planning, which are not typically associated with acute mania.
B. Isolating oneself from others could be a sign of depression rather than acute mania.
C. Reporting a lack of sleep is characteristic of acute mania, as individuals in manic episodes often experience decreased need for sleep.
D. Refusing to engage in conversation could be indicative of various factors, but it is not specific to acute mania.

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Body system	Findings
Neurological	Impaired cognition

	Insomnia Seizures
Cardiovascular	Increased blood pressure Increased heart rate Diaphoresis
Gastrointestinal	Lack of appetite Vomiting
Musculoskeletal	Malaise Tremulousness

A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive therapy (ECT). The client refuses the treatment and will not discuss why with the health care team. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating?

Correct Answer is A

Explanation

A nurse is assessing a client who has bipolar disorder. Which of the following findings should the nurse identify as an indication that the client is experiencing acute mania?

Correct Answer is C

Explanation

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