After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?

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Kaplan and Sadocks Synopsis of Psychiatry Test Bank Questions

Question 1 of 9

After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?

Correct Answer: C

Rationale: The correct answer is C. It acknowledges the client's autonomy while also addressing their concerns. First, it recognizes the client's right to discontinue treatment. Second, it opens the door for a discussion to explore the client's worries and provide support. This response shows empathy and respects the client's decision-making. Choice A is incorrect because it dismisses the client's autonomy and fails to address their concerns. Choice B is not as appropriate as it suggests only talking to the doctor, missing the opportunity for the nurse to provide immediate support. Choice D is incorrect as it invalidates the client's experience of memory loss and fails to address their concerns.

Question 2 of 9

A patient asks, “What advantage does a durable power of attorney for health care have over a living will?” The nurse should reply, A durable power of attorney for health care:

Correct Answer: A

Rationale: Correct Answer: A: Gives your agent authority to make decisions during any illness if you are incapacitated. Rationale: 1. A durable power of attorney for health care allows you to appoint a trusted individual (agent) to make medical decisions on your behalf if you are unable to do so. 2. This authority is not limited to a specific type of illness or condition, ensuring your agent can make decisions for any illness that renders you incapacitated. 3. This flexibility ensures that your wishes are carried out regardless of the circumstances. Summary of Other Choices: B: Incorrect - A durable power of attorney can be given to any trusted individual, not just a relative. C: Incorrect - A durable power of attorney can be used in any situation where you are unable to make decisions, not just in terminal illness. D: Incorrect - A durable power of attorney can be implemented immediately upon signing, providing timely decision-making support.

Question 3 of 9

Which activities should the nurse evaluate in an assessment of an older patient’s functional status? (Select all that apply.)

Correct Answer: A,C

Rationale: The correct answers are A and C. A nurse should evaluate if the older patient can prepare nutritious meals independently, as this indicates their ability to meet basic nutritional needs and maintain independence in daily living. Additionally, assessing if the patient can perform regular, simple maintenance on their primary residence is important for gauging their ability to live safely and comfortably. Choices B and D are incorrect as financial resources and toileting abilities, while important, do not directly reflect functional status in the same way as meal preparation and home maintenance.

Question 4 of 9

The nurse is determining whether the patient’s needs could be best met in a task or a process group. The decision is based on the understanding that a task group focuses on:

Correct Answer: A

Rationale: The correct answer is A: The "here and now." In a task group, the focus is on addressing specific goals, tasks, and problem-solving in the present moment. This approach helps members work together efficiently to achieve objectives. Communication styles (B) are more relevant in a group focused on improving communication skills. Relations among the members (C) are typically emphasized in a process group, where the focus is on interpersonal dynamics and relationships. Choice D is incomplete and does not align with the purpose of a task group.

Question 5 of 9

During a bereavement group, one of the members states, “I should have been the one to die. My husband had so much to offer.” The member was expressing:

Correct Answer: A

Rationale: The correct answer is A: Ambivalence and low self-esteem. The member's statement reflects conflicting emotions (ambivalence) about her worth compared to her husband's. This indicates low self-esteem, as she believes she is less valuable. Unresolved anger (B) would involve blaming her husband, not herself. A need for attention (C) is not evident, as she is sharing personal feelings. Depression (D) may be present, but the statement specifically points to self-deprecation, not just a general feeling of sadness.

Question 6 of 9

A teenage boy has lost his best friend as a result of a hunting accident. His parents report that he is eating and sleeping very little and expresses little interest in school. They are concerned that he talks about the accident repeatedly. These behaviors are generally seen as:

Correct Answer: C

Rationale: The correct answer is C: Expressions of a normal grief reaction. The teenage boy's behaviors of poor appetite, insomnia, lack of interest in school, and repetitive discussions about the accident are common manifestations of grief. This grief reaction is a normal response to losing a close friend in a traumatic manner like a hunting accident. It is important to acknowledge and validate his emotions during this difficult time. Incorrect Choices: A: Expressing responsibility for his friend's death - This choice suggests guilt or blame on the part of the boy, which is not evident in the scenario. B: Attempts to avoid dealing with his pain - The boy's behaviors indicate he is processing his grief rather than avoiding it. D: Indications of a risk for self-harm - While it is important to monitor for signs of self-harm, the behaviors described are more indicative of grief rather than immediate self-harm risk.

Question 7 of 9

During a grief-processing group, an elderly patient stated, “For the first time since my husband died, I’m having more good days than bad.” This statement suggests that the patient has:

Correct Answer: C

Rationale: The correct answer is C: Completed her "grief work" successfully. This statement indicates progress in the grieving process, moving towards acceptance and healing. The patient acknowledging having more good days than bad reflects a positive shift in coping with the loss, indicating that she has processed her grief and is beginning to adapt to life without her husband. This suggests that the patient has worked through her emotions, memories, and adjustments related to the loss, reaching a point where she is experiencing more peace and acceptance. Summary: A: Reestablishment is not the correct choice as it does not specifically address the completion of the grief work. B: Determining readiness to terminate the support group is premature, as the patient may still benefit from continued support. D: Replacing old memories with new ones is not supported by the patient's statement and does not necessarily indicate successful grief processing.

Question 8 of 9

About an hour after the patient has ECT, he complains of having a headache. The nurse should:

Correct Answer: B

Rationale: The correct answer is B: Administer an as needed (prn) dose of acetaminophen. After ECT, it is common for patients to experience headaches as a side effect. Administering acetaminophen will help alleviate the headache and provide relief for the patient. It is important to address the patient's discomfort promptly and effectively. Choice A is incorrect because headaches after ECT are a common side effect and do not typically require immediate physician notification. Choice C is incorrect as progressive relaxation may not address the immediate headache symptoms. Choice D is also incorrect as physical activities may exacerbate the headache rather than provide relief. Administering acetaminophen is the most appropriate and efficient intervention in this situation.

Question 9 of 9

Which intervention would qualify as primary prevention of violent behaviors in children and adolescents?

Correct Answer: B

Rationale: The correct answer is B because limiting exposure to violence on TV, video, and computer games falls under primary prevention by addressing risk factors before violent behaviors occur. This intervention helps reduce the likelihood of children and adolescents developing violent tendencies by minimizing their exposure to violent content that can influence their behavior. A: Forbidding the child to continue friendships with violent peers is more of a secondary prevention strategy targeting existing risk factors, not primary prevention. C: Seeking counseling for a child who has been experimenting with drugs is also a secondary prevention strategy focusing on addressing a specific risk factor, not primary prevention. D: Showing a unified approach to parenting when dealing with a violent child is a tertiary prevention strategy aimed at managing and reducing harm after the behavior has already occurred, not primary prevention.

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