PN VATI Mental Health Questions and verified Answers
PN VATI Mental Health Questions and verified Answers 1. A nurse is assisting with the care of a client immediately following elec- troconvulsive therapy (ECT). Which of the following findings should the nurse document as an unexpected response to the procedure?:correct ans: Irregular heart rhythm An irregular heart rhythm is an unexpected response to ECT. During the procedure, the client's heart can be stressed, which can cause cardiac abnormalities. especially if the client already has impaired cardiac function. The nurse should document this finding and notify the charge nurse or the client's provider. 2. A nurse is caring for a client who is admitted for alcohol use disorder. The client states, "I have not had anything to drink for 24 hours." Which the following is the priority nursing intervention?:correct ans: Check the client's vital signs. Clients who have alcohol use disorder are at risk for the development of abstinence syndrome. Manifestations of abstinence syndrome occur 12 to 72 hr after the client has last consumed alcohol and can include tachycardia, hypertension, and an elevated temperature. Therefore, the first action the nurse should take when using the airway, breathing, circulation (ABC) approach to client care is to check the client's vital signs to monitor for signs of abstinence syndrome.
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