A nurse is preparing a client for electroconvulsive therapy (ECT). Which of the following client statements indicates an understanding of the procedure?

Correct Answer: A

Rationale: In the context of preparing a client for electroconvulsive therapy (ECT), it is crucial for the client to have a clear understanding of what to expect during the procedure. Option A, "This procedure will cause me to have brief seizures," is the correct answer because it accurately reflects the nature of ECT. ECT involves inducing a controlled seizure in the brain to help alleviate symptoms of certain mental health conditions. Option B, "I will be able to eat breakfast prior to my procedure," is incorrect because typically, clients undergoing ECT are required to fast prior to the procedure to reduce the risk of complications such as aspiration. Option C, "I will not need to have a pre-ECT workup before the procedure," is incorrect because a thorough pre-ECT workup is essential to ensure the client's safety and appropriateness for ECT treatment. Option D, "One ECT treatment will be effective for my depression," is incorrect because ECT is usually administered over a series of treatments to achieve optimal therapeutic benefits. From an educational perspective, it is important for nurses to provide accurate information to clients undergoing ECT to alleviate anxiety and ensure informed decision-making. Understanding the procedure helps clients feel more in control and engaged in their treatment, ultimately leading to better outcomes.

Correct Answer: D

Rationale: In the context of working with a patient diagnosed with post-traumatic stress disorder (PTSD), the most appropriate intervention is option D: Help the patient identify coping mechanisms and support systems. This is the correct choice because individuals with PTSD often benefit from learning and utilizing coping strategies to manage symptoms and navigate daily challenges. By helping the patient identify coping mechanisms tailored to their specific needs, the nurse empowers the individual to better regulate their emotions, reduce anxiety, and improve overall well-being. Option A, providing exposure therapy to confront trauma-related memories, may not be suitable initially as it can be overwhelming and retraumatizing for some individuals with PTSD. Gradual exposure under professional guidance may be more appropriate. Option B, encouraging the patient to avoid any discussions about the traumatic event, is not recommended as avoidance can perpetuate symptoms and hinder the healing process in the long run. It is important for individuals with PTSD to process and work through their experiences in a safe and supportive environment. Option C, administering sedative medications to manage anxiety during flashbacks, may be a short-term solution for acute distress but does not address the underlying issues associated with PTSD. Medications should be used in conjunction with therapy and coping strategies for optimal outcomes. In an educational context, understanding the rationale behind choosing appropriate interventions for individuals with PTSD is crucial for healthcare professionals. By prioritizing the identification of coping mechanisms and support systems, nurses can actively contribute to the holistic care and recovery of patients with PTSD, fostering resilience and empowerment in their journey towards healing.

Correct Answer: C

Rationale: In the scenario where a patient diagnosed with major depressive disorder expresses a desire to commit suicide, the nurse's priority intervention is option C: Ensure the patient is in a safe environment and not at risk for harm. This intervention takes precedence as it addresses the immediate safety and well-being of the patient. Ensuring the patient is in a safe environment involves removing any potential means for self-harm, closely monitoring the patient, and possibly initiating the appropriate interventions such as suicide precautions or involving the mental health team for further assessment and management. Option A, reassuring the patient that they are not alone, and option B, encouraging the patient to express their feelings and emotions, are important aspects of therapeutic communication and support in mental health nursing. However, in a situation where there is an imminent risk of harm, ensuring the patient's safety must take precedence over these interventions. Option D, asking the patient to sign a no-suicide contract, is not an appropriate intervention in this critical situation. No-suicide contracts do not guarantee safety or prevent suicide attempts. They should not be used as a substitute for proper risk assessment and safety planning. In an educational context, it is crucial for nurses to prioritize patient safety in mental health crises. Understanding the hierarchy of interventions and the importance of immediate risk assessment and management is essential for providing effective and safe care to patients experiencing suicidal ideation. Effective communication skills and therapeutic interventions play a vital role in supporting these patients, but safety always comes first in such critical situations.

Correct Answer: B

Rationale: The most appropriate intervention for a patient diagnosed with generalized anxiety disorder is to provide relaxation techniques such as deep breathing (Option B). This is because deep breathing exercises are a widely recognized evidence-based strategy for managing anxiety. Deep breathing helps activate the body's relaxation response, which can counter the physiological arousal associated with anxiety. Encouraging the patient to confront their fears directly (Option A) may actually exacerbate their anxiety and lead to increased distress. It is important not to push individuals with anxiety disorders into situations that may trigger overwhelming anxiety. Reassuring the patient that their anxiety is not warranted (Option C) is not helpful as it may invalidate their feelings and experiences. Anxiety disorders are real and valid mental health conditions that require understanding and appropriate interventions. Encouraging the patient to avoid stressful situations whenever possible (Option D) can contribute to the perpetuation of anxiety and limit the individual's ability to cope and adapt to challenging circumstances. Avoidance can lead to increased fear and avoidance behaviors, ultimately worsening the anxiety symptoms. In an educational context, it is crucial for healthcare providers, including nurses, to be well-versed in evidence-based interventions for anxiety disorders. By understanding the most effective strategies like deep breathing techniques, nurses can provide optimal care and support to patients with generalized anxiety disorder, promoting their overall well-being and mental health.

Correct Answer: B

Rationale: Assessing cognition involves determining a patient's judgment and decision making. In this case, the nurse would expect a response of 'Call my doctor' if the patient's cognition and judgment are intact. If the patient responds, 'I would stop eating' or 'I would just wait and see what happened,' the nurse would conclude that judgment is impaired. The other options refer to other aspects of the examination.