Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has given informed consent for electroconvulsive therapy (ECT). Just before the procedure, the client expresses to the nurse that she is having second thoughts and is considering not going through with the treatment. What is the most appropriate response for the nurse in this situation?
A. "It's understandable to feel nervous before this treatment. Most people feel better after, but you have the right to change your mind at any time."
Acknowledges the client's feelings:It's important for the nurse to validate the client's concerns and let them know that it's understandable to feel nervous or uncertain about ECT. Provides information about the treatment:The nurse can offer information about the potential benefits of ECT,but it's important not to pressure the client or make them feel like they have to go through with it. Reassures the client of their right to change their mind:This is a crucial aspect of informed consent.The client has the right to withdraw their consent at any time,even after signing the consent form.
B. "I know this is a difficult decision, but the doctor believes ECT is the best option for you. Are you sure you want to cancel?"
Places undue pressure on the client:This response implies that the doctor knows what's best for the client and that the client should go through with the treatment even if they have doubts.This can undermine the client's autonomy and decision-making ability.
C. "That's completely fine! We can reschedule for another time when you're feeling more ready."
May minimize the client's concerns:While rescheduling the treatment is an option,it's important to explore the client's concerns more thoroughly before suggesting this.It's possible that the client has valid reasons for not wanting to go through with ECT,and these reasons should be addressed.
D. "You signed the consent form, so you need to go through with the treatment. It's important to follow through on your commitments."
Is disrespectful of the client's autonomy:This response suggests that the client is obligated to go through with the treatment simply because they signed a consent form.This ignores the fact that people can change their minds and that consent is an ongoing process.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Comprehensive Predictor 2023 Exit Proctored Exam A. Take the full exam now
Full Explanation
The correct answer is Choice A.
Choice A rationale:
- Acknowledges the client's feelings: It's important for the nurse to validate the client's concerns and let them know that it's understandable to feel nervous or uncertain about ECT.
- Provides information about the treatment: The nurse can offer information about the potential benefits of ECT, but it's important not to pressure the client or make them feel like they have to go through with it.
- Reassures the client of their right to change their mind: This is a crucial aspect of informed consent. The client has the right to withdraw their consent at any time, even after signing the consent form.
Choice B rationale:
- Places undue pressure on the client: This response implies that the doctor knows what's best for the client and that the client should go through with the treatment even if they have doubts. This can undermine the client's autonomy and decision-making ability.
Choice C rationale:
- May minimize the client's concerns: While rescheduling the treatment is an option, it's important to explore the client's concerns more thoroughly before suggesting this. It's possible that the client has valid reasons for not wanting to go through with ECT, and these reasons should be addressed.
Choice D rationale:
- Is disrespectful of the client's autonomy: This response suggests that the client is obligated to go through with the treatment simply because they signed a consent form. This ignores the fact that people can change their minds and that consent is an ongoing process.
Similar Questions
A nurse is caring for a client who has given informed consent for electroconvulsive therapy. Just before the procedure, the client tells the nurse she is considering not going forward with the treatment.
A. “It’s okay to be nervous before this treatment.”.
It’s okay to be nervous before this treatment.” is wrong because it minimizes the patient’s feelings and does not address the patient’s wish to cancel the treatment. It may also imply that the patient’s doubts are irrational or unfounded, which may undermine the patient’s trust and confidence in the nurse.
B. “Most people who have this procedure feel better following the treatment.”.
C. “Your doctor wouldn’t have ordered this treatment unless it was necessary.”.
D. “You don’t have to go through with the treatment
This is because informed consent is a fundamental principle in medical decision-making, and it requires that the patient has the capacity, information, and voluntariness to consent to a treatment. Electroconvulsive therapy (ECT) is a treatment that involves applying electrical currents to the brain to induce seizures and improve symptoms of certain mental disorders. ECT has proven efficacy and safety, but it also has potential risks and side effects, such as memory impairment, headache, nausea, and confusion. Therefore, patients who are considering ECT should be fully informed of the benefits and risks of the procedure, as well as the alternatives and consequences of refusing treatment. If a patient who has given informed consent for ECT expresses doubts or reluctance before the procedure, the nurse should respect the patient’s autonomy and right to withdraw consent at any time. The nurse should not coerce, manipulate, or pressure the patient to undergo ECT, but rather provide support, reassurance, and clarification as needed. The nurse should also inform the patient’s doctor and the ECT team of the patient’s change of mind, and explore the reasons and concerns behind the patient’s decision.
A quality control nurse is reviewing medication prescriptions for a group of clients.
Which of the following medication prescriptions should the nurse identify as being complete?
A. Cimetidine PO twice daily.
is wrong because it does not specify the dose of cimetidine. PO twice daily is not enough information to administer the medication safely.
B. Tetracycline 200 mg PO.
wrong because it does not specify the frequency of tetracycline. 200 mg PO is not enough information to administer the medication safely.
C. Epoetin alfa 150 units/kg three times weekly.
wrong because it does not specify the route of epoetin alfa. 150 units/kg three times weekly is not enough information to administer the medication safely.
D. Digoxin 0.25 mg PO daily. Answer and explanation.
This prescription is complete because it includes the medication name, dose, route, and frequency. A complete prescription should also include the client’s name, date, time, signature of the prescriber, and any special instructions.
Full Explanation
This prescription is complete because it includes the medication name, dose, route, and frequency.
A complete prescription should also include the client’s name, date, time, signature of the prescriber, and any special instructions.
Choice A is wrong because it does not specify the dose of cimetidine.
PO twice daily is not enough information to administer the medication safely.
Choice B is wrong because it does not specify the frequency of tetracycline.
200 mg PO is not enough information to administer the medication safely.
Choice C is wrong because it does not specify the route of epoetin alfa.
150 units/kg three times weekly is not enough information to administer the medication safely.
Normal ranges for digoxin are 0.5 to 2 ng/mL for heart failure and 0.8 to 2 ng/mL for atrial fibrillation.
Normal ranges for cimetidine are 50 to 150 ng/mL.
Normal ranges for tetracycline are 1 to 10 mcg/mL.
Normal ranges for epoetin alfa are not applicable as it is a synthetic hormone that stimulates red blood cell production.
A nurse is obtaining a client’s manual blood pressure and is having difficulty auscultating sounds.
Which of the following actions should the nurse take?
A. Apply the largest cuff available.
is wrong because applying the largest cuff available can result in a falsely low reading. The cuff size should be appropriate for the client’s arm circumference.
B. Use the palpatory method to determine blood pressure.
Use the palpatory method to determine blood pressure. This method involves feeling the radial pulse while inflating and deflating the cuff.
C. Place the arm above the level of the client’s heart.
is wrong because placing the arm above the level of the client’s heart can also cause a falsely low reading. The arm should be at the level of the heart for an accurate measurement.
D. Deflate the cuff quickly.
is wrong because deflating the cuff quickly can lead to missing or skipping sounds, resulting in an inaccurate reading. The cuff should be deflated slowly and evenly. Normal ranges for blood pressure vary depending on age, sex, and health conditions, but generally, a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg are considered normal for adults.
Full Explanation
The systolic pressure is estimated by noting the pressure at which the pulse disappears and reappears. The diastolic pressure is not measured by this method, but it can be useful when the sounds are difficult to hear.
Choice A is wrong because applying the largest cuff available can result in a falsely low reading. The cuff size should be appropriate for the client’s arm circumference.
Choice C is wrong because placing the arm above the level of the client’s heart can also cause a falsely low reading. The arm should be at the level of the heart for an accurate measurement.
Choice D is wrong because deflating the cuff quickly can lead to missing or skipping sounds, resulting in an inaccurate reading. The cuff should be deflated slowly and evenly.
Normal ranges for blood pressure vary depending on age, sex, and health conditions, but generally, a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg are considered normal for adults.