Which client would the nurse expect to prepare for electroconvulsive therapy (ECT)?

A male client with severe long-lasting major depression and at risk for suicide

A male client with major depressive disorder and history of heart disease

A female client with dysthymic disorder

A female client with major depression and brain metastasis

Answer and Explanation

The Correct Answer is A

A. ECT is often considered for severe major depression that has not responded to other treatments, especially when there is a risk of suicide. ECT can provide rapid relief of symptoms, which is crucial in cases where immediate intervention is needed to prevent harm to the patient.

B. While ECT is generally safe for individuals with medical conditions, including heart disease, special precautions might be needed. However, the presence of heart disease alone would not necessarily preclude ECT if the benefits outweigh the risks and if the client's cardiac status is stable.

C. Dysthymic disorder, characterized by persistent depressive symptoms that are less severe than major depression, typically does not warrant ECT. ECT is usually reserved for more severe forms of depression that significantly impair daily functioning or pose a risk to the patient's safety.

D. ECT may be contraindicated or require careful consideration in clients with brain metastasis due to potential risks related to increased intracranial pressure or neurological complications. Alternative treatments may be preferred in such cases.

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Correct Answer is A

Explanation

A. Lithium is excreted primarily by the kidneys, and its clearance can be affected by changes in fluid balance. It's important for clients taking lithium to maintain a stable and adequate fluid intake to help regulate lithium levels in the body. Stable fluid intake helps maintain electrolyte balance, which is crucial for the proper function of lithium and prevention of adverse effects.

B. Lithium can affect sodium reabsorption in the kidneys. High levels of sodium intake can alter lithium levels in the body, potentially leading to toxicity. Therefore, clients on lithium therapy are often advised to maintain a consistent and moderate level of sodium intake. Excessive dietary salt can interfere with lithium's therapeutic effects.

C. Restricting fluid intake is not recommended unless there are specific medical reasons to do so. Lithium therapy generally requires adequate hydration to maintain kidney function and prevent dehydration, which can affect lithium levels.

D. Exercising in hot weather can lead to increased sweating and fluid loss, which can potentially affect lithium levels by altering hydration status. However, the primary concern during exercise in hot weather is maintaining adequate hydration rather than restricting it.

A. Low serum sodium level B. Low serum sodium level C. Low serum potassium Ievel D. High serum potassium level

Correct Answer is C

Explanation

C This is a common and potentially life-threatening complication in individuals with anorexia nervosa who are undergoing treatment. It can lead to cardiac arrhythmias.

A. Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can also contribute to hyponatremia by causing the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which leads to water retention and dilutional hyponatremia. However, it is not as life-threatening as hypokalemia.

B. Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. However, it is not as life-threatening as hypokalemia.

D. Anorexia nervosa typically does not lead to hyperkalemia (high serum potassium level), as potassium is usually lost through purging behaviors or inadequate intake. Antidepressants also do not commonly cause hyperkalemia as a side effect.

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Which client would the nurse expect to prepare for electroconvulsive therapy (ECT)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which instruction should the nurse give a client who is prescribed lithium carbonate (lithium)?

Correct Answer is A

Explanation

A female client with anorexia nervosa and a cardiac condition was prescribed an antidepressant before she regained weight during her treatment course. The nurse should be aware of the possibility of which condition in this client?

Correct Answer is C

Explanation

A depressed client has been prescribed a selective serotonin reuptake inhibitor. Which medication may have been prescribed?

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The death rate from anorexia is higher than any other mental illness. Death usually results from which of the following? (Select all that apply.)

Depression in adolescence usually is related to loneliness, family strengths, self-esteem, and which of the following?

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