An older adult client is brought into the behavioral health outpatient clinic by a family member. The family member is concerned that the client is hoarding again. Which information obtained by the family member is of most concern to the nurse that correlates with the suspicion? (Select all that apply.)

A large number of cats living in the home.

When trying to remove items, the client becomes angry and upset.

Unable to enter into the rooms due to clutter piled up.

The client is obsessively cleaning the same areas repeatedly.

The client is throwing away items in the home that are deemed "unnecessary."

Answer and Explanation

Correct Answer : B,C

Choice A reason: While having a large number of pets can be a sign of hoarding, it is not necessarily a concern unless it negatively impacts the living conditions.

Choice B reason: Becoming angry and upset when attempting to remove items is a common reaction in individuals who hoard, indicating an emotional attachment to possessions.

Choice C reason: Inability to enter rooms due to clutter is a clear sign of hoarding, as it indicates that the accumulation of items has significantly interfered with the intended use of living spaces.

Choice D reason: Obsessive cleaning of the same areas may indicate a different issue, such as obsessive-compulsive disorder, rather than hoarding.

Choice E reason: Throwing away items deemed "unnecessary" is not typically associated with hoarding behavior, as hoarding involves difficulty parting with items.

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Correct Answer is C

Explanation

Choice A reason: Making significant life changes immediately after rehab can be overwhelming and might not be advisable as the client adjusts to sobriety.

Choice B reason: Focusing on long-term outcomes can be motivating, but it is also important to have short-term goals to maintain sobriety.

Choice C reason: Abstaining from alcohol is a fundamental part of maintaining sobriety and indicates an understanding of the importance of avoiding triggers.

Choice D reason: Returning to life as it was before rehab can be risky without making changes to support sobriety, such as avoiding triggers and continuing therapy.

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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Naxlex Comprehensive Predictor Exams

The nurse is educating a client with alcoholism who has been in rehabilitation for two weeks to prepare for discharge. Which statement made by the client indicates that education was effective and the client is best prepared for discharge?

Correct Answer is C

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

A nurse is discussing comorbidities associated with eating disorders with a newly admitted client. Which of the following conditions should the nurse include in the discussion? (Select all that apply)

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.)

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

A female client comes to the clinic regularly for various somatic issues that have been ruled out for any organic cause. She states that she works as one of the only women on a cybersecurity technical team. Which statement made by the client indicates that she may have suppressed anger?

The nurse is caring for a client who delivered a newborn 2 days ago and states that they are experiencing crying spells, anxiety, and sadness that started the day after delivery. Which is the most therapeutic action by the nurse?

The nurse is talking with the spouse of a client admitted for substance use disorder and overdose. Which statement(s) made by the spouse indicates that they are exhibiting enabling behaviors? Select all that apply.

The nurse has established a therapeutic relationship with a client. Which behaviors indicate that the client has entered into the identification phase of the nurse-client relationship?

A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?