Nokea
Which activity therapy should the nurse recommend to the treatment team to assist the patient to relieve tension and achieve increased body awareness?
- A. Music therapy
- B. Dance therapy
- C. Recreation
- D. Relaxation exercises
Correct Answer: B
Rationale: Dance therapy is a form of activity therapy that uses movement and dance to promote emotional, social, cognitive, and physical integration and well-being. It can help individuals relieve tension, connect with their bodies, and increase body awareness. Through dancing, patients can release emotions, express themselves non-verbally, and improve their overall sense of well-being. Additionally, dance therapy can also help improve muscle tone, coordination, and flexibility, thereby contributing to physical health. Overall, dance therapy can be a beneficial intervention to assist the patient in relieving tension and achieving increased body awareness.
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An elderly patient must be physically restrained. Who is responsible for the patient's safety?
- A. Unlicensed assistive personnel who apply the restraint
- B. Family member who agrees to the application of the restraint
- C. The nurse assigned to care for the patient.
- D. Health care provider who prescribed the application of restraint
Correct Answer: C
Rationale: The nurse is responsible for the patient’s safety, including the appropriate use of restraints and ensuring the patient is monitored appropriately. The nurse is accountable for assessing the need for restraints, their proper application, and ongoing evaluation of the patient’s condition while restrained
What milieu factor would need most attention from the nurse who is caring for a patient who has received six ECT treatments and has two more sc\
- A. Therapeutic activities
- B. Boundary maintenance
- C. Safety
- D. Trust attainment
Correct Answer: C
Rationale: When caring for a patient who has received multiple electroconvulsive therapy (ECT) treatments and has more scheduled, the most critical milieu factor that needs attention is safety. ECT is a medical procedure that involves inducing seizures through electrical stimulation, and patients may be at risk of physical harm during or after the treatments. The nurse should prioritize ensuring the patient's safety during and after the ECT sessions, including monitoring for any adverse effects, providing support, and taking necessary precautions to prevent accidents. Safety measures, such as fall prevention protocols and close observation, are essential in the care of patients undergoing ECT to ensure their well-being. Therefore, safety is the milieu factor that requires the most attention in this situation.
Which statement would the nurse use to describe the primary purpose of boundaries?
- A. Boundaries define responsibilities and duties to one’s self in relation to others.
- B. Boundaries determine objectives of the various working stage of the relationship.
- C. Boundaries differentiate the assumed roles of both the nurse and of the patient.
- D. Boundaries prevent undesired material from emerging during the interaction.
Correct Answer: A
Rationale: Boundaries define responsibilities and duties to one’s self in relation to others. Setting boundaries is essential in establishing a safe and professional therapeutic relationship between a nurse and a patient. These boundaries help to create a clear understanding of each person's roles and responsibilities within the relationship. Boundaries also help protect both the nurse and the patient from potential harm, maintain professionalism, and ensure effective communication and focus on the therapeutic goals. By defining these boundaries, the nurse can better maintain appropriate relationships with patients and avoid conflicts of interest or ethical dilemmas.
Immediately after electroconvulsive therapy, in which position should a nurse place the client?
- A. On his or her side to prevent aspiration.
- B. In semi-Fowlers position to promote oxygenation
- C. In Trendelenburg’s position to promote blood flow to vital organs
- D. In prone position to prevent airway blockage
Correct Answer: A
Rationale: Immediately after ECT, the patient may still be recovering from the effects of muscle relaxants and the seizure. Positioning the client on their side helps prevent aspiration in case of vomiting and maintains an open airwa
In the ECT treatment preparation period the morning of treatment, the nurse should:
- A. Assess the patient’s cognitive function.
- B. Have the patient exercise for 10 minutes.
- C. Ensure that the patient produces a urine sample.
- D. Allow the patient to eat a heavy meal if they are hungry.
Correct Answer: A
Rationale: The correct action during the ECT treatment preparation period the morning of treatment is to adequately hydrate the patient. Ensuring that the patient is properly hydrated before the procedure is crucial for their safety and well-being. Hydration helps optimize the effects of the treatment and can support the patient's recovery post-treatment. It is important to maintain the patient's fluid balance as ECT can sometimes cause side effects such as nausea, headache, and muscle aches, which can be worsened if the patient is not adequately hydrated. Additionally, hydration can help prevent complications such as dehydration or electrolyte imbalances during and after the ECT procedure.