Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia. The nurse should follow these steps for this procedure (place in the order they will occur):

Questions 29

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Kaplan and Sadocks Synopsis of Psychiatry Questions Questions

Question 1 of 9

Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia. The nurse should follow these steps for this procedure (place in the order they will occur):

Correct Answer: C

Rationale: Rationale: 1. Educating the patient and family is crucial as it helps alleviate anxiety and ensures informed consent. 2. Monitoring vital signs (A) should be done before, during, and after the procedure, not necessarily in a specific order. 3. Medication administration (B) should be based on physician's orders but is not the initial step. 4. Checking a signed consent (D) is important but typically done before proceeding with any procedure, not necessarily in a specific order.

Question 2 of 9

Which intervention should the nurse plan to reduce the patient's focus on delusional thinking?

Correct Answer: D

Rationale: The correct answer is D because focusing on the feelings suggested by the delusion can help the patient process and manage their emotions underlying the delusion. By addressing the emotions, the nurse can help the patient gain insight into the delusion and reduce its intensity. Confronting the delusion (A) may lead to resistance and reinforcement. Refuting the delusion with logic (B) may further alienate the patient. Exploring reasons for the delusion (C) may not directly address the emotional component.

Question 3 of 9

When a patient asks the nurse, “How can jolting me with an electrical shock possibly do me any good?” the answer most reflective of current biologic theory would be:

Correct Answer: A

Rationale: Step 1: Electroconvulsive therapy (ECT) is a treatment for severe depression and other mental health disorders. Step 2: Current biological theory suggests that ECT produces changes in brain chemistry, specifically neurotransmitters, leading to improved mood. Step 3: The correct answer (A) aligns with this theory by explaining how ECT impacts brain chemistry to alleviate symptoms. Step 4: Answer B is incorrect as ECT is not used as punishment but as a therapeutic intervention. Step 5: Answer C is incorrect as ECT is not primarily used to interrupt brain impulses causing hallucinations and delusions. Step 6: Answer D is incorrect as ECT does not shock the brain into re-establishing normal electrical patterns but rather affects neurotransmitter levels.

Question 4 of 9

The nurse determines that the most effective point of intervention for bereavement is:

Correct Answer: A

Rationale: The correct answer is A because promoting mental and spiritual health across the lifespan addresses bereavement proactively by providing support and resources before, during, and after losses occur. This approach allows individuals to build resilience and cope effectively with grief. Choice B is incorrect as it focuses on impending loss, missing the opportunity for early intervention. Choice C is incorrect as immediate intervention may not be suitable for everyone and may overlook the importance of ongoing support. Choice D is incorrect as waiting for the patient to request intervention may delay support and hinder the healing process.

Question 5 of 9

An elderly couple who lived in the same home for the past 50 years have moved into an adult retirement center in a nearby town. Changes in lifestyle such as this couple is experiencing should alert the nurse to the possibility of:

Correct Answer: D

Rationale: The correct answer is D: Adventitious crisis. This type of crisis is triggered by external events such as moving to a retirement center after 50 years in the same home. The sudden change in environment can lead to distress and challenges for the elderly couple, causing an adventitious crisis. Acute grief (A) and traumatic grief (B) are typically associated with the loss of a loved one, not a change in lifestyle. Chronic sorrow (C) refers to ongoing grief related to a chronic illness or disability, which is not the case in this scenario.

Question 6 of 9

Which statement best defines the nurse’s initial role as the patient’s source of help in addressing interpersonal problems?

Correct Answer: B

Rationale: The correct answer is B because it emphasizes the nurse's role in actively working with the patient to address interpersonal problems. The nurse's initial role is to provide support and assistance to the patient in resolving their issues collaboratively. Choice A focuses on medical treatment and collaboration with the doctor, not specifically addressing interpersonal problems. Choice C solely emphasizes the role of medications in improving the patient's well-being, neglecting the interpersonal aspect. Choice D suggests passing off the responsibility to other professionals, which contradicts the nurse's initial role as a source of help for the patient. In summary, choice B is correct because it highlights the nurse's active involvement in solving the patient's interpersonal problems.

Question 7 of 9

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 8 of 9

Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia. The nurse should follow these steps for this procedure (place in the order they will occur):

Correct Answer: C

Rationale: Rationale: 1. Educating the patient and family is crucial as it helps alleviate anxiety and ensures informed consent. 2. Monitoring vital signs (A) should be done before, during, and after the procedure, not necessarily in a specific order. 3. Medication administration (B) should be based on physician's orders but is not the initial step. 4. Checking a signed consent (D) is important but typically done before proceeding with any procedure, not necessarily in a specific order.

Question 9 of 9

A teen is grieving the loss of her pet dog. She states to her mother, “I miss my dog so much, but I know that if I start crying, I will never stop.” The teen is expressing a fear of:

Correct Answer: D

Rationale: The correct answer is D: Losing control over her emotions. The teen's statement indicates a fear of losing control if she starts crying. This fear suggests that she believes crying will lead to an inability to stop, indicating a concern about managing her emotions. This fear of losing control over her emotions aligns with the teen's hesitance to express her grief through tears. A: Appearing emotionally immature - This choice is incorrect as the teen's statement does not directly suggest a fear of appearing emotionally immature. B: Embarrassing herself by crying in public - This choice is incorrect as the teen's statement does not mention a fear of embarrassment. C: Losing the support of her friends and family - This choice is incorrect as the teen's statement does not indicate a fear of losing support from others.

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