Question 1

A client who is learning about ECT asks a nurse,&#34;Isn't this treatment dangerous?&#34; Which is the most appropriate nursing reply?&#10;A)&#34;ECT is not dangerous because there are no side effects.&#10;B)&#34;There can be temporary paralysis,but full functioning returns within 3 hours of treatment.&#34;&#10;C)&#34;You will have a thorough examination beforehand to ensure you can safely undergo ECT.&#34;&#10;D)&#34;Transient ischemic attacks can occur but are rare.&#34;

Accepted Answer

The most appropriate nursing reply is to educate the client that they will undergo a thorough examination beforehand to ensure safe ECT treatment. This helps the client understand the importance of assessment and safety in the process. A is not correct as ECT does have side effects. B is partially correct but may sound alarming to the client. D is not the best choice as it may not provide clear information to the client.

Question 2

A client scheduled for ECT at 9:00 a.m.is discovered eating breakfast at 8:00 a.m.Based on this observation,which is the most appropriate nursing action?&#10;A)The nurse notifies the client's physician of the situation and cancels the ECT.&#10;B)The nurse removes the breakfast tray and assists the client to the ECT procedure room.&#10;C)The nurse allows the client to finish breakfast and reschedules ECT for 10:00 a.m.&#10;D)The nurse increases the client's fluid intake to facilitate the digestive process.

Accepted Answer

Electroconvulsive therapy (ECT) requires that the patient be fasted for several hours prior to the procedure to reduce the risk of aspiration during the treatment. If a patient eats before ECT, the procedure should be postponed and the physician notified to prevent potential complications.

Question 3

A client states,&#34;My doctor has told me I am a candidate for ECT.Where will the treatment take place,and how much time would this entail?&#34; Which nursing reply is best?&#10;A)&#34;Clients typically receive ECT in their hospital room,daily for 1 month.&#34;&#10;B)&#34;Clients typically undergo 6 to 12 ECT procedures,three times a week in an outpatient setting.&#34;&#10;C)&#34;Clients typically receive an unlimited number of treatments,in the hospital procedure room.&#34;&#10;D)&#34;Clients typically receive two to three treatments,in either an outpatient or inpatient setting.&#34;

Accepted Answer

Option B states the most commonly used protocol for ECT, which involves 6 to 12 procedures done three times a week in an outpatient setting. This response provides the client with a clear and concise answer to their question. Option A is incorrect because ECT typically takes place in a dedicated treatment area, not in the client's hospital room. Option C is incorrect because ECT is not an unlimited procedure and is typically limited by the client's response to the treatment. Option D is incorrect because two to three treatments are not sufficient for most clients and the location of the treatment can vary depending on the client's needs.

Question 4

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

A)Suicide assessment must continue throughout the ECT course.
B)Antidepressant medications are contraindicated throughout the ECT course.
C)Discourage expressions of hopelessness throughout the ECT course.
D)Encourage a high-caloric diet throughout the ECT course.

Accepted Answer

Suicide assessment should continue throughout the ECT course because ECT can cause transient confusion and disorientation, which may increase the risk of suicidal thoughts and behaviors. It is important to monitor the client closely and provide support to prevent self-harm. Antidepressant medications are not necessarily contraindicated during the ECT course, and discouraging expressions of hopelessness may be counterproductive to the therapeutic process. Encouraging a high-caloric diet is not a critical intervention during the ECT course.

Question 5

Which position should the nurse place the client in immediately after ECT?&#10;A)On his or her side to prevent aspiration&#10;B)In semi-Fowler's position to promote oxygenation&#10;C)In Trendelenburg's position to promote blood flow to vital organs&#10;D)In prone position to prevent airway blockage

Accepted Answer

The nurse should place the client on his or her side to prevent aspiration of any gastric contents that may have been present in the client's stomach during the procedure.

Question 6

A nurse administers pure oxygen to a client during and after electroconvulsive therapy (ECT).What is the nurse's rationale for this procedure?&#10;A)To prevent increased intracranial pressure resulting from anoxia&#10;B)To prevent hypotension,bradycardia,and bradypnea due to electrical stimulation&#10;C)To prevent anoxia due to medication-induced paralysis of respiratory muscles&#10;D)To prevent blocked airway resulting from seizure activity

Accepted Answer

During ECT, the client is given medication-induced paralysis of respiratory muscles, which can lead to anoxia. Administering pure oxygen helps prevent anoxia by ensuring adequate oxygenation.

Question 7

Which assessment results should the nurse evaluate and report to prepare a client for ECT? Select all that apply.&#10;A)Electrocardiographic (ECG)records&#10;B)Pulmonary function study results&#10;C)Electroencephalogram analysis&#10;D)Complete blood count values&#10;E)Urinalysis results

Accepted Answer

The answer of Which assessment results should the nurse evaluate...

Question 8

A client experienced bradycardia during ECT.A nurse assigns a nursing diagnosis of decreased cardiac output R/T vagal stimulation occurring during ECT.Which outcome would the nurse expect the client to achieve?

A)The client will verbalize an understanding of the need for moving slowly after treatment.
B)The client will maintain an oxygen saturation level of 88 percent 1 hour after treatment.
C)The client will continue adequate tissue perfusion 1 hour after treatment.
D)The client will verbalize an understanding of common side effects of ECT.

Accepted Answer

The nursing diagnosis of decreased cardiac output indicates that there is an inadequate amount of blood being pumped by the heart, which can lead to decreased tissue perfusion. The desired outcome would be for the client to maintain adequate tissue perfusion, which is indicated by a normal blood pressure, heart rate, and oxygen saturation level. A and D are not directly related to the nursing diagnosis and B is not a relevant outcome for treating bradycardia.

Question 9

A nursing student is observing an ECT procedure.The student notices a blood pressure cuff on the client's lower leg.The student questions the instructor about the cuff placement.Which is the most accurate instructor reply?

A)"The cuff has to be placed on the leg because both arms are used for IV fluids."
B)"The cuff functions to prevent succinylcholine from reaching the foot."
C)"The cuff position gives a more accurate blood pressure reading during the treatment."
D)"The cuff is placed on the leg so that arms can easily be restrained during seizure."

Accepted Answer

The placement of the blood pressure cuff on the client's lower leg during an ECT procedure is to prevent the administration of succinylcholine from reaching the foot. Succinylcholine is a muscle relaxant that is administered during the procedure to prevent injury from convulsions, but it can cause temporary paralysis if it reaches the foot. By placing the cuff on the lower leg, the flow of succinylcholine is restricted to the upper part of the body during the procedure.

Question 10

A nursing instructor is teaching about the medications given prior to and during ECT.Which student statement indicates learning has occurred?&#10;A)&#34;Atropine sulfate is administered to paralyze skeletal muscles during ECT.&#34;&#10;B)&#34;Succinylcholine chloride (Anectine)decreases secretions to prevent aspiration.&#34;&#10;C)&#34;Thiopental sodium (Pentothal)is a short-acting anesthesia to render the client unconscious.&#34;&#10;D)&#34;Glycopyrrolate (Robinul)is given to prevent severe muscle contractions during seizure.&#34;

Accepted Answer

Thiopental sodium is a short-acting anesthesia used to render the client unconscious during ECT. Atropine sulfate is used to increase heart rate and secretions, not to paralyze skeletal muscles. Succinylcholine chloride is a muscle relaxant used during ECT, but it is not used to decrease secretions. Glycopyrrolate is used to decrease secretions, not to prevent severe muscle contractions during seizure.

Question 11

A client with cognitive deficits is extremely suicidal.The client has not responded to antidepressants and the treatment team is considering ECT.Which client information would impact the feasibility of this treatment option?

A)Because the client is extremely suicidal,ECT is an appropriate option.
B)Because antidepressant medications have been ineffective,ECT is a good alternative.
C)Because informed consent is required for ECT,cognitive deficits could preclude this option.
D)Because of the client's cognitive deficits,a signed consent is waived.

Accepted Answer

The answer of A client with cognitive deficits is extremely...

Question 12

Which of the following conditions place a client at risk for injury during ECT? Select all that apply.&#10;A)Severe osteoporosis&#10;B)Acute and chronic pulmonary disorders&#10;C)Hypothyroidism&#10;D)Recent cardiovascular accident&#10;E)Prostatic hypertrophy

Accepted Answer

The answer of Which of the following conditions place a...

Question 13

Immediately after an initial ECT procedure,a client states,&#34;I'm not hungry and just want to stay in bed and sleep.&#34; Based on this information,which is the most appropriate nursing intervention?&#10;A)Allow the client to remain in bed.&#10;B)Encourage the client to join the milieu to promote socialization.&#10;C)Obtain a physician's order for parenteral nutrition.&#10;D)Involve the client in physical activities to stimulate circulation.

Accepted Answer

The answer of Immediately after an initial ECT procedure,a client...

Question 14

A nurse administers ordered preoperative glycopyrrolate (Robinul)30 minutes prior to a client's ECT procedure.What is the rationale for administering this medication?&#10;A)Robinul decreases anxiety during the ECT procedure.&#10;B)Robinul induces an unconscious state to prevent pain during the ECT procedure.&#10;C)Robinul prevents severe muscle contractions during the ECT procedure.&#10;D)Robinul decreases secretions to prevent aspiration during the ECT procedure.

Accepted Answer

The answer of A nurse administers ordered preoperative glycopyrrolate (Robinul)30...

Question 15

The nurse recognizes that ECT would potentially improve the symptoms of clients with which of the following diagnoses? Select all that apply.&#10;A)Major depressive disorder&#10;B)Bipolar I disorder: Acute mania&#10;C)Schizoaffective disorder&#10;D)Obsessive-compulsive disorder (OCD)&#10;E)Body dysmorphic disorder

Accepted Answer

The answer of The nurse recognizes that ECT would potentially...

Question 16

A client is scheduled for an initial ECT procedure.Which information will the nurse include when teaching about the potential side effects of ECT?&#10;A)&#34;You may experience transient tangential thinking.&#34;&#10;B)&#34;You may experience some memory deficit surrounding the ECT.&#34;&#10;C)&#34;You may experience avolution for the remainder of the day.&#34;&#10;D)&#34;You may experience a higher risk for subsequent seizures.&#34;

Accepted Answer

The answer of A client is scheduled for an initial...

Question 17

After undergoing two of nine ECT procedures,a client states,&#34;I can't even remember eating breakfast,so I want to stop the ECT.&#34; Which is the most appropriate nursing reply?&#10;A)&#34;After you begin the course of treatments,you must complete all of them.&#34;&#10;B)&#34;You'll need to talk with your doctor about what you're thinking.&#34;&#10;C)&#34;It is within your right to discontinue the treatments,but let's talk about your concerns.&#34;&#10;D)&#34;Memory loss is a rare side effect of the treatment.I don't think it should be a concern.&#34;

Accepted Answer

The answer of After undergoing two of nine ECT procedures,a...

Question 18

A nursing instructor is teaching about ECT.Which student statement indicates that learning has occurred?&#10;A)&#34;During ECT,a state of euphoria is induced.&#34;&#10;B)&#34;ECT induces a grand mal seizure.&#34;&#10;C)&#34;During ECT,a state of catatonia is induced.&#34;&#10;D)&#34;ECT induces a petit mal seizure.&#34;

Accepted Answer

The answer of A nursing instructor is teaching about ECT.Which...

Question 19

During a course of 12 ECT procedures,an anxious client diagnosed with MDD refuses to bathe or attend group therapy.The client reports some memory problems and says he has trouble figuring out what time of day it is.Which of the following nursing diagnoses should be assigned to this client? Select all that apply.

A)Anxiety R/T post-ECT confusion and memory loss
B)Risk for injury R/T post-ECT confusion and memory loss
C)Risk for activity intolerance R/T post-ECT confusion and memory loss
D)Altered sensory perception R/T post-ECT confusion and memory loss
E)Social isolation R/T post-ECT confusion and memory loss

Accepted Answer

The answer of During a course of 12 ECT procedures,an...

Question 20

When scheduling ECT,which client should the nurse prioritize?&#10;A)A client in bed in a fetal position who is experiencing active suicidal ideations&#10;B)A client with an irritable mood who is exhibiting angry outbursts&#10;C)A client experiencing command hallucinations and delusions of reference&#10;D)A client experiencing manic episodes of bipolar disorder

Accepted Answer

The answer of When scheduling ECT,which client should the nurse...

Deck 20: Electroconvulsive Therapy