A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT, a nurse should recognize the continued need for which critical intervention?

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Kaplan and Sadocks Synopsis of Psychiatry Questions Questions

Question 1 of 5

A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT, a nurse should recognize the continued need for which critical intervention?

Correct Answer: A

Rationale: The correct answer is A because suicide assessment must continue throughout the ECT course to ensure the safety and well-being of the client. During ECT, the client may experience changes in mood and behavior, which could impact their risk of suicide. It is essential for the nurse to monitor and assess the client's suicidal ideation and intent regularly. This ongoing assessment helps in identifying any exacerbation of suicidal thoughts and allows for timely intervention to prevent self-harm. Choice B is incorrect because antidepressant medications are not necessarily contraindicated throughout the ECT course. In some cases, a client may still require antidepressants in addition to ECT for optimal treatment outcomes. Choice C is incorrect because it is important to acknowledge and validate the client's feelings of hopelessness rather than discouraging them. By addressing and exploring these feelings, the nurse can provide support and facilitate the client's emotional processing. Choice D is incorrect because encouraging a high-caloric diet is not directly related to the critical intervention needed during

Question 2 of 5

Which description is characteristic of an impulsive child?

Correct Answer: A

Rationale: The correct answer is A. An impulsive child typically acts without thinking or considering consequences, such as running into the street without looking. This behavior is impulsive, risky, and disregards safety instructions. Choices B and C describe behaviors that are more indicative of other issues like hyperactivity or hallucinations. Choice D suggests difficulty concentrating, which is not directly related to impulsivity. In summary, the key characteristic of an impulsive child is acting quickly without considering potential dangers or instructions.

Question 3 of 5

A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient’s needs?

Correct Answer: B

Rationale: The correct answer is B: Adult day care program. This option best meets the needs of the patient as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient during the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide activities to stimulate cognitive function. Explanation of other choices: A: Skilled nursing facility - Not ideal as the patient does not require 24-hour nursing care. C: Partial hospitalization - Typically for individuals needing intensive mental health services, not suitable for this patient's needs. D: Group home - Usually for individuals who need more permanent residential care, not appropriate for the patient's situation.

Question 4 of 5

When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?

Correct Answer: C

Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause symptoms of delirium or exacerbate confusion in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced causes of confusion and adjust the treatment accordingly. Choice A (Evidence of spasticity or flaccidity) is incorrect because these symptoms are more related to neurological conditions such as stroke or spinal cord injury, not specifically delirium. Choice B (The patient’s level of motor activity) is not as relevant in distinguishing delirium from other problems as medication history, as motor activity can be influenced by various factors. Choice D (Level of preoccupation with somatic symptoms) is also less relevant compared to medication history in differentiating delirium, as somatic symptoms may not always directly indicate the underlying cause of confusion in elderly patients.

Question 5 of 5

Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.

Correct Answer: A

Rationale: The correct answer is A: Behavioral health home care. This option provides ongoing assessment, socialization opportunities, and education about medication and relapse prevention, which are all essential for the elderly patient with major depression. Additionally, it allows the patient to stay in their own home environment, promoting comfort and familiarity. Option B: Partial hospitalization may not provide the ongoing support and socialization opportunities needed for the patient. Option C: A skilled nursing facility may offer medical care but may not focus on mental health needs or socialization. Option D: A halfway house is typically for individuals transitioning from addiction treatment and may not address the specific needs of an elderly patient with major depression.

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