Correct Answer: A

Rationale: ECT is often considered for severe major depression that has not responded to other treatments, especially when there is a risk of suicide. ECT can provide rapid relief of symptoms, which is crucial in cases where immediate intervention is needed to prevent harm to the patient. While ECT is generally safe for individuals with medical conditions, including heart disease, special precautions might be needed. However, the presence of heart disease alone would not necessarily preclude ECT if the benefits outweigh the risks and if the client's cardiac status is stable. Dysthymic disorder, characterized by persistent depressive symptoms that are less severe than major depression, typically does not warrant ECT. ECT is usually reserved for more severe forms of depression that significantly impair daily functioning or pose a risk to the patient's safety. ECT may be contraindicated or require careful consideration in clients with brain metastasis due to potential risks related to increased intracranial pressure or neurological complications. Alternative treatments may be preferred in such cases.

Correct Answer: C

Rationale: Dysthymia is a type of persistent depressive disorder characterized by a depressed mood that lasts for at least two years. It typically involves emotional and behavioral symptoms rather than physical symptoms without clinical findings. Body dysmorphic disorder involves a preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others. While it involves body image concerns, it does not manifest as physical symptoms in the absence of objective findings. Somatoform disorders are characterized by physical symptoms that suggest a medical condition but cannot be fully explained by a general medical condition, another mental disorder, or substance use. Individuals with somatoform disorders often experience distress or impairment due to these symptoms despite medical reassurance that no physical cause can be found. Major depressive disorder primarily involves mood disturbances such as sadness, loss of interest or pleasure, and changes in appetite or sleep. While physical symptoms like fatigue and changes in weight can occur, they are not typically reported persistently without objective clinical findings as seen in somatoform disorders.

Correct Answer: A

Rationale: Lithium is excreted primarily by the kidneys, and its clearance can be affected by changes in fluid balance. It's important for clients taking lithium to maintain a stable and adequate fluid intake to help regulate lithium levels in the body. Stable fluid intake helps maintain electrolyte balance, which is crucial for the proper function of lithium and prevention of adverse effects. Lithium can affect sodium reabsorption in the kidneys. High levels of sodium intake can alter lithium levels in the body, potentially leading to toxicity.
Therefore, clients on lithium therapy are often advised to maintain a consistent and moderate level of sodium intake. Excessive dietary salt can interfere with lithium's therapeutic effects. Restricting fluid intake is not recommended unless there are specific medical reasons to do so. Lithium therapy generally requires adequate hydration to maintain kidney function and prevent dehydration, which can affect lithium levels. Exercising in hot weather can lead to increased sweating and fluid loss, which can potentially affect lithium levels by altering hydration status. However, the primary concern during exercise in hot weather is maintaining adequate hydration rather than restricting it.

Correct Answer: D

Rationale: Dissociative amnesia is characterized by significant memory loss that cannot be explained by ordinary forgetfulness. If a client experiences sudden travel and cannot remember how they arrived at a distant location, it could indicate dissociative amnesia. Hospitalization is not absolutely necessary. Dissociative disorders are primarily treated with psychotherapy rather than medication adjustments. However, if medication adjustments are necessary for co-occurring conditions or to manage symptoms like anxiety or depression, hospitalization is not necessary. Monitoring of identities is typically done on an outpatient basis, unless there are additional complications or risks identified by a healthcare professional. Dissociative disorders, particularly post-traumatic stress disorder (PTS
D) and acute stress disorder, can involve the reliving of traumatic events through flashbacks, nightmares, or intrusive memories. Hospitalization may be required if the client experiences severe distress, is at risk of self-harm or harm to others during flashbacks.

Correct Answer: A,B,D,E

Rationale: A. Severely restricted food intake can lead to imbalances in electrolytes such as potassium, sodium, and chloride. These imbalances can disrupt normal heart rhythm (arrhythmias) and other vital functions, potentially leading to cardiac arrest, which is a common cause of death in individuals with anorexia nervosa. B. Individuals with anorexia nervosa are at increased risk of suicidal thoughts and behaviors. This risk may be due to the severe psychological distress associated with the disorder, as well as the physical complications that can feel overwhelming. Suicide can unfortunately be a tragic consequence in some cases. D. Dehydration is a significant risk in individuals with anorexia nervosa, especially when combined with electrolyte imbalances. Dehydration can lead to organ failure, particularly kidney failure, which can be life-threatening if not promptly treated. E. Severe muscle wasting can occur in individuals with anorexia nervosa, particularly in later stages of the disorder. Loss of muscle mass contributes to overall physical weakness and compromises essential bodily functions, potentially leading to organ failure and death. C. Anorexia nervosa itself does not directly cause diabetes. However, individuals with severe anorexia may develop metabolic disturbances, including insulin resistance, due to malnutrition. This can lead to abnormal blood sugar levels, but diabetes as a direct cause of death in anorexia is less common compared to other complications.