Which nursing diagnosis would be most appropriate for the client who has undergone the full course of electroconvulsive therapy (ECT)?

Deficient knowledge related to memory loss

Noncompliance related to knowledge deficit

Disturbed thought processes related to adverse effects of ECT

Fear related to the unknown

Answer and Explanation

The Correct Answer is A

Electroconvulsive therapy (ECT) is a highly effective treatment for severe major depressive disorder, especially when pharmacologic options fail. While ECT can rapidly alleviate symptoms, it is associated with transient memory loss, particularly around the time of treatment. Post-ECT care focuses on educating clients about expected cognitive changes, monitoring recovery, and reinforcing understanding of the procedure’s effects. Most memory deficits resolve over time, but confusion or concern may persist without proper education.

Rationale for correct answer

1. After completing ECT, clients often experience memory loss, especially short-term or retrograde amnesia. If the client lacks understanding of this expected side effect, the most appropriate nursing diagnosis is deficient knowledge. Education helps reduce anxiety and promotes realistic expectations about recovery and cognitive function.

Rationale for incorrect answers

2. Noncompliance implies refusal or failure to follow treatment, which is not applicable post-ECT if the client has completed the full course. The issue is not adherence but understanding of residual effects.

3. Disturbed thought processes suggest cognitive disorganization, hallucinations, or delusions, which are not typical post-ECT. Mild confusion may occur transiently, but it does not meet the criteria for this diagnosis unless severe or persistent.

4. Fear related to the unknown is relevant before ECT, when clients may be anxious about the procedure. After completion, the focus shifts to recovery and education, not anticipatory fear.

Take Home Points

Memory loss is a common and expected side effect of ECT, requiring post-treatment education.
Noncompliance is not applicable once the treatment course is completed.
Thought disturbances are not typical post-ECT unless other psychiatric symptoms persist.
Pre-treatment fear transitions to post-treatment knowledge needs in nursing care planning.

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Correct Answer is A

Explanation

Major depressive disorder (MDD) has a multifactorial etiology involving genetic, neurobiological, and environmental components. Family and twin studies show that individuals with a first-degree relative diagnosed with a mood disorder have a significantly increased risk of developing MDD. Genetic predisposition is linked to variations in genes regulating serotonin transport, neuroplasticity, and stress response. Heritability estimates range from 30–50%, with higher risks observed in families with recurrent or early-onset mood disorders.

Rationale for correct answer

1. A family history of bipolar affective disorder reflects a genetic vulnerability to mood disorders, including MDD. Bipolar disorder and MDD share overlapping genetic markers, and having a first-degree relative with either condition increases the likelihood of developing depressive symptoms due to inherited neurobiological traits.

Rationale for incorrect answers

2. This statement reflects current mood status and safety assessment, not etiology. It provides clinical information about emotional state and risk but does not indicate any underlying genetic or familial predisposition.

3. This reflects a psychosocial factor—childhood trauma—which is an environmental contributor to depression. While significant, it does not represent genetic etiology and instead points to experiential influences on emotional development.

4. Feelings of worthlessness are a symptom of depression, not a cause. This statement illustrates cognitive distortions typical in MDD but does not provide insight into the origin or contributing factors of the disorder.

Take Home Points

Genetic predisposition plays a significant role in the development of major depressive disorder.
Family history of mood disorders increases risk due to shared neurobiological traits.
Environmental factors like trauma also contribute but are distinct from genetic etiology.
Symptoms of depression reflect the disorder’s manifestation, not its underlying cause.

A. Say, “Come with me. I will go with you to group therapy.” B. Make frequent short visits to her room and sit with her. C. Offer to introduce her to the other clients. D. Help her to identify stressors in her life that precipitate crises.

Correct Answer is B

Explanation

Depression with psychomotor retardation often presents as withdrawal, slowed movements, and diminished verbal engagement. Clients may appear disengaged or nonresponsive, but this reflects internal suffering rather than defiance. Establishing a therapeutic alliance requires consistent presence, emotional attunement, and non-demanding interaction. Early interventions should prioritize trust-building over verbal or social engagement, especially when the client is isolating.

Rationale for correct answer

2. Making short, frequent visits and sitting quietly communicates presence without pressure. This approach respects the client’s current emotional state and initiates connection through nonverbal support. It lays the foundation for trust and future engagement by showing reliability and empathy without demanding interaction.

Rationale for incorrect answers

1. Inviting the client to group therapy prematurely may feel overwhelming and intrusive. It assumes readiness for social interaction, which contradicts her current withdrawn behavior and may increase anxiety or resistance.

3. Introducing her to other clients is premature and socially demanding. It bypasses the essential first step of building a one-on-one therapeutic relationship and may reinforce feelings of isolation if she declines.

4. Exploring stressors requires verbal engagement and insight, which the client is not currently demonstrating. This intervention is more appropriate once rapport is established and the client is emotionally ready to reflect.

Take Home Points

Psychomotor retardation in depression requires gentle, nonverbal therapeutic engagement.
Trust-building precedes verbal or social interventions in severely withdrawn clients.
Avoid overwhelming clients with premature group or social activities.
Consistent, quiet presence is a powerful tool in initiating therapeutic relationships.

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Which nursing diagnosis would be most appropriate for the client who has undergone the full course of electroconvulsive therapy (ECT)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which client statement is evidence of the etiology of major depressive disorder from a genetic perspective?

Correct Answer is A

Explanation

A newly admitted depressed client isolates herself in her room and just sits and stares into space. How best might the nurse begin an initial therapeutic relationship with this client?

Correct Answer is B

Explanation

Which is the key to understanding if a child or adolescent is experiencing an underlying depressive disorder?

Which nursing diagnosis supports the psychoanalytic theory of development of major depressive disorder?

Which of the following medications may be administered before electroconvulsive therapy? Select all that apply.

The nurse is interviewing a client admitted to an in-patient psychiatric unit with major depressive disorder. Which is the primary goal in the assessment phase of the nursing process for this client?

A client has just been admitted to the psychiatric unit with a diagnosis of major depressive disorder. Which of the following behavioral manifestations might the nurse expect to assess? Select all that apply.

Which nursing diagnosis would be most appropriate for the client who has undergone the full course of electroconvulsive therapy (ECT)?

Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations?

A client recently diagnosed with depression tells a nurse that she is 2 months pregnant and is reluctant to take an antidepressant medication. The client asks what other treatment options are available. Which type of therapy should a nurse recommend as an alternate treatment for depression?