A nurse is providing teaching about relapse prevention to a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Keeping restraints on for a set minimum like 1 hour ignores the least restrictive principle, risking harm if the child calms sooner. Restraints require frequent reassessment, not arbitrary duration, to ensure safety and circulation. This rigid approach violates guidelines, making it unsafe and inappropriate.

Choice B reason: Monitoring vital signs every 15 minutes ensures the child’s safety in restraints, detecting distress, hypoxia, or injury from aggression or positioning. Conduct disorder doesn’t negate physiological risks, and standards mandate close observation. This action prioritizes well-being, aligning with protocol, making it the correct choice.

Choice C reason: Renewing restraint orders every 24 hours is standard but not immediate; it addresses future use, not current safety post-initiation. The priority is real-time monitoring, not administrative renewal. This action delays focus on the child’s acute state, so it’s not the top priority now.

Choice D reason: An in-person evaluation within 2 hours is ideal but secondary to immediate safety checks like vital signs. Regulations often allow 1-4 hours for provider review, depending on age, but monitoring precedes this. It’s important but not the first action, making it less urgent.

Choice A reason: Electroconvulsive therapy (ECT) isn’t a primary treatment for borderline personality disorder, which relies on psychotherapy like DBT. ECT targets severe mood disorders, not personality traits like emotional instability. Improvement in BPD symptoms wouldn’t indicate ECT efficacy, as it’s not the intended outcome. This finding misaligns with ECT’s clinical purpose.

Choice B reason: Reduced seizure frequency relates to epilepsy management, not ECT, which induces controlled seizures to treat psychiatric conditions. Effectiveness isn’t measured by fewer spontaneous seizures but by mood improvement. This outcome reflects a misunderstanding of ECT’s mechanism, making it an incorrect indicator of success.

Choice C reason: ECT is primarily used for severe depression, especially when medications fail, by altering brain chemistry via induced seizures. Improvement in depressive symptoms—elevated mood, energy, or appetite—directly indicates efficacy, aligning with its therapeutic goal. This finding confirms ECT’s intended effect, making it the correct measure.

Choice D reason: Decreased fear of heights suggests phobia improvement, treated by exposure therapy, not ECT. ECT focuses on mood disorders, not specific anxiety conditions unrelated to depression. This outcome doesn’t reflect ECT’s purpose or mechanism, so it’s not a valid indicator of treatment success here.