NUR 221 PrepU Psychiatric and Mental Health Nursing 100% Pass
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Course
NUR 221 PrepU Psychiatric and Mental Health Nursi
Institution
NUR 221 PrepU Psychiatric And Mental Health Nursi
NUR 221 PrepU Psychiatric and Mental
Health Nursing 100% Pass
A client is in the geriatric psychiatry inpatient unit. The client has bilateral electroconvulsive
therapy (ECT) scheduled for tomorrow. Which intervention would be most important for the
nurse to implement for this client?
A. E...
NUR 221 PrepU Psychi atric and Mental Health Nursing 100% Pass A client is in the g eriatric psychiatry inpatient unit. The client has bilateral electroconvulsive therapy (ECT) scheduled for tomorrow. Which intervention would be most important for the nurse to implement for this client? A. Encourage fluids 6 to 8 hours before the treatmen t. B. Encourage caffeine intake the day before treatment. C. Provide frequent, supportive reorientation after the treatment. D. Encourage the family to accompany the client to the treatment. C. Provide frequent, supportive reorientation after the treatment. Rationale: Common side effects of bilateral ECT treatments are confusion, disorientation, and short -term memory loss. The nurse should plan frequent, brief, and succinct reorientation statements. The client is frequently NPO after midnight prior to ECT therapy. Caffeine augmentation to ECT therapy would occur immediately prior to the procedure via intravenous administration. Family would be helpful for the client postprocedure but would not necessarily be part of the plan of care for the procedure. The nurse is collecting data to determine whether a client is experiencing dementia or depression. Which findings indicate dementia? Select all that apply. A. The progression of symptoms is slow. B. The client answers questions with, "I don't know." C. The client acts apathetic and pessimistic. D. The family cannot identify when symptoms first appeared. E. The client's basic personality has changed. F. The client has great difficulty paying attenti on to others. A. The progression of symptoms is slow. D. The family cannot identify when symptoms first appeared. E. The client's basic personality has changed. F. The client has great difficulty paying attention to others. Rationale: Common characteristi cs of dementia include slow onset of symptoms, difficulty identifying when symptoms first occurred, noticeable changes in the client's personality, and impaired ability to pay attention to others. Options 2 and 3 are symptoms of depression, not dementia. While shopping, a nurse meets a neighbor who asks about a friend receiving treatment at the nurse's clinic. What is the nurse's most appropriate response? A. "It might be best if you discuss this with the client directly." B. "I'm sorry, I can't disclose client information." C. "You should probably try to call your friend for an update." D. "I can only say your friend is stable and seems to be doing well." B. "I'm sorry, I can't disclose client information." Rationale: The nurse is bound by the rules of confidentiality and can't reveal any information about a client or treatment, and shou ld state this fact to the neighbor. Suggesting that the neighbor call the client is inappropriate because the nurse is inadvertently disclosing information and acknowledging the client's presence at the clinic. Saying that the client is stable and doing well is a blatant violation of the client's right to absolute confidentiality. The client with major depression and suicidal ideation has been taking bupropion 100 mg PO 3 times daily for 5 days. Assessment reveals the client to be somewhat less withdrawn, a ble to perform activities of daily living with minimal assistance, and eating 50% of each meal. At this time, the nurse should monitor the client specifically for which behavior? A. Visual disturbances. B. Increased libido. C. Suicide attempt. D. Seizure a ctivity. C. Suicide attempt. Rationale: The nurse must monitor the client for a suicide attempt at this time when the client is starting to feel better because the depressed client may now have enough energy to carry out an attempt. Bupropion inhibits dop amine reuptake; it is an activating antidepressant and could cause agitation. Although bupropion lowers the seizure threshold, especially at doses greater than 450 mg/day, and visual disturbances and increased libido are possible adverse effects, the nurse must closely monitor the client for a suicide attempt. As the client with major depression begins to feel better, the client may have enough energy to carry out an attempt. The nurse attempts to interact with a client who barely responds with yes or no. T he client states, "Don't bother me. I want to die." What action should the nurse take? A. Send another staff member to interact with the client. B. Leave the client alone. C. Turn on the television for the client. D. Sit with the client. D. Sit with the cl ient. Rationale: The nurse sits in silence with the client who is severely depressed. The nurse's presence conveys concern for and acceptance of the client, provides security, increases self -
worth, and gives some structure to the client's day. Leaving the client alone ignores the client's needs and does nothing to foster trust in the nurse. Sending another staff member to interact with the client does not help the client gain trust and may be interpreted as the nurse not wanting to be "bothered." Turning o n the television for the client completely blocks communication and diverts attention away from the client's needs. A client with dementia who prefers to stay in his room has been brought to the dayroom. After 10 minutes, the client becomes agitated and re treats to his room again. The nurse decides to assess the conditions in the dayroom. Which is most likely the occurrence that is disturbing to this client? A. A housekeeping staff member is washing off the countertops in the kitchen, which is on the far si de of the dayroom. B. A relaxation tape is playing in one corner of the room, and a television airing a special on
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