Mood Disorders Practice Exam/Test (9-15)

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9. Most people respond emotionally to the thought of electric current passing through their brain. When discussing the subject with the patient, the nurse should:

a) use the term "shock" in a neutral, calm manner
b) refer to the procedure as the patient's "treatment" instead of "shock therapy"
c) refer to it as ECT
d) explain how the convulsions are artificially induced

10. B. and her husband begin to express concern about the proposed ECT treatment. Which nursing action is most appropriate initially?

a) refer all questions to the physician who will actually administer ECT treatment
b) listen for misconceptions and clarify any confusing information
c) orient B. and her husband to the ECT unit so they become familiar and comfortable with the surroundings
d) provide B. and her husband with booklets explaining the procedure in simple, understandable terms

11. By providing B. and her husband with an opportunity to discuss ECT treatment openly and directly, the nurse communicates the idea that:

a) ECT should not be feared
b) ECT will reverse the depression
c) ECT is a positive treatment alternative
d) ECT is a safe procedure

12. B. ask the nurse, "Why do I have to sign a consent form?" Which response is most appropriate?

a) it indicates that you have been fully informed about the procedure and the risk involved
b) your physician should have explained this to you yesterday. Didn't he tell you about signing a consent?
c) it's just a hospital rule. Sign here please
d) most of the medications used can be dangerous. Your consent is required

13. When B. returns to her room after awakening from the ECT treatment, the nurse should:

a) place a "No visitors" sign on the door so she can rest undisturbed
b) perform a complete physical examination
c) orient her to person, place and time
d) remain with her until all confusion disappears

14. Which other nursing action should the nurse perform after the patient returns from ECT treatment?

a) take vital signs every 15 minutes for the next 2 hours
b) open all locked closets so the patient can have access to her belongings
c) offer the patient a cigarette if she smokes, to help her relax
d) touch the patient by grasping her hand or massaging her shoulders while talking to her

15. Which side effects are most common among ECT treatment?

a) headache and dizziness
b) diarrhea and urinary incontinence
c) nausea and vomiting
d) temporary memory loss and confusion




ANSWERS AND RATIONALE

9) B
- to emphasize the therapeutic value of ECT, the nurse should refer to it as the patient's "treatment." Although "ECT" is medically correct terminology, this term should not be used unless the patient is familiar and comfortable with it; referring to the procedure as ECT may cause the patient to focus on the disturbing elements of this treatment. Such terms as "convulsions" and "shock" tend to increase a patient's anxiety and should therefore be avoided.

10) B
- although controversial, ECT is an effective treatment for depression. Many people have negative images about ECT treatment that may have arisen from reading about ECT or watching movies in which it is portrayed as barbaric or inhumane. The nurse can be most helpful by listening carefully to the patient to assess her fears and needs and then determining how to intervene. If needed, the patient then can be referred to the physician, oriented to the area, or given booklets explaining the procedure. The patient has the right to make an informed consent and, if competent, to refuse any treatment, including ECT.

11) C
- openly discussing the proposed ECT treatment places an appropriate emphasis on accepting the therapeutic value of the procedure. The nurse should be supportive while realistically discussing the treatment outcomes, the patient's fears, and any potential untoward effects of the ECT treatment. Because ECT involves the use of an anesthetic and the passing of an electric current through thee brain, fear is a normal, expected outcome. Although ECT has proved to be an effective treatment for lessening the degree of depression, it is not guaranteed to reverse the depression. In the role of patient advocate, the nurse cannot imply that there are no safety concerns. Although uncommon, such adverse effects as permanent memory loss, periodic hypertension, and stroke can occur.

12) A
- the nurse should estate the purpose of signing a consent form, which is to ensure that the patient has been informed of the benefits and risks of the procedure. The patient probably is anxious and may have forgotten what she was told earlier. The consent form is an important legal document, and the patient has the right to know its purpose; even if the physician explained the procedure, the patient must understand what she is signing before she signs it. The patient's signature indicates awareness and understanding, not just compliance with hospital policy. Because ECT involves risks other than those associated with medication, these risks must be fully understood.

13) C
- a patient returning from ECT treatment typically is confused and disoriented. The nurse's task is to reassure the patient by orienting her to person, place, and time. Although the patient will be tired, she can received visitors. A complete physical assessment is not needed after ECT treatment. The nurse cannot remain with the patient until all confusion disappears because this may take several days.

14) D
- touch reinforces verbal encouragement, demonstrates caring, strengthens interactions, and establishes the nurse's presence and availability. Vital signs are monitored in the recovery room until the patient is stable. Until the patient is fully alert and ambulatory, the nurse should keep the closets locked to protect the patient's valuables. The patient should not be permitted to smoke until she can safely go to smoking area.

15) D
- temporary memory loss and confusion are the most common side effects of ECT treatment and occur in all age-groups. Many patients experience some degree of headache, but dizziness is not a common complaint. Diarrhea and urinary incontinence generally do not occur. Some patients become nauseated and may require an antiemetic medication, but this side effect is rarely seen.



Related Topics:

• Online Nursing Practice Test about Mood Disorders (16-23)
• Go back to Online Nursing Practice Test about Mood Disorders (1-8) to start the test from the beginning.