ECT and Brain Stimulation Therapies Practice Questions
11 free ECT and Brain Stimulation Therapies practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which pre-procedure nursing action is most appropriate for a patient scheduled for Electroconvulsive Therapy (ECT)?
- A Withhold all food and fluids for a full 24 hours before the procedure.
- B Ensure informed consent is signed after discussing risks and benefits.
- C Perform the mental-status assessment only after the procedure is done.
- D Give the usual morning antidepressant just before transport to the suite.
Correct answer: Ensure informed consent is signed after discussing risks and benefits.
Informed consent is a fundamental nursing responsibility prior to ECT, including discussion of risks, benefits, alternatives, and the procedure itself. Pre-procedure fasting is shorter (usually 6–8 h) for anesthesia, not 24 h; mental-status baseline should be recorded before the procedure for comparison; administering usual antidepressants just before ECT may increase risk of complications.
What is the primary rationale for using ECT in psychiatric practice?
- A To stimulate continuous brain activity without inducing any seizure.
- B To induce a brief generalized seizure under anesthesia for therapeutic effect.
- C To non-invasively apply magnetic fields to the superficial cortex only.
- D To implant a permanent electrode in the brain for deep stimulation.
Correct answer: To induce a brief generalized seizure under anesthesia for therapeutic effect.
ECT involves applying electrical current to trigger a brief, controlled generalized seizure under anesthesia, which is thought to effect therapeutic changes in brain chemistry and neural networks.
Which of the following patients is the best candidate for ECT?
- A A patient with mild, stable depression responding well to first-line drugs.
- B A patient with severe major depression and suicidal ideation, unresponsive to multiple medications.
- C A patient with untreated glaucoma and only mild ongoing anxiety.
- D A patient with well-controlled hypertension and occasional bouts of insomnia.
Correct answer: A patient with severe major depression and suicidal ideation, unresponsive to multiple medications.
ECT is typically indicated when other treatments have failed, or rapid response is needed (e.g., suicidality) in severe depression, bipolar disorder, catatonia, or psychosis.
During the ECT procedure, what physiological monitoring is essential?
- A EEG, ECG, pulse oximetry, and blood pressure.
- B Glucose monitoring only.
- C Skin temperature of the lower extremities.
- D No monitoring is required because patient is under anesthesia.
Correct answer: EEG, ECG, pulse oximetry, and blood pressure.
Monitoring of EEG (to document seizure activity), ECG, pulse oximetry, and blood pressure is essential during ECT to ensure patient safety, observe seizure duration, and respond to hemodynamic changes.
After a patient completes a course of ECT, which cognitive side effect should the nurse monitor most closely?
- A Markedly improved long-term memory recall within days of treatment.
- B Retrograde memory loss for events just before the procedure.
- C Noticeably improved fine motor coordination.
- D A sustained enhancement of creative thinking.
Correct answer: Retrograde memory loss for events just before the procedure.
One of the known side effects of ECT is retrograde amnesia (difficulty recalling events prior to the treatment) and sometimes anterograde memory issues; these require monitoring post-treatment.
Which nursing intervention is unique to patients undergoing Transcranial Magnetic Stimulation (TMS) compared to ECT?
- A The patient is placed under general anesthesia during the procedure.
- B No sedation is needed and the patient stays awake and alert.
- C A muscle relaxant is given to block any convulsive movement.
- D The patient must fast for at least 12 hours before treatment.
Correct answer: No sedation is needed and the patient stays awake and alert.
Unlike ECT, TMS is non-invasive, does not require general anesthesia, and the patient remains awake and alert during the procedure.
Which statement captures a key distinction between TMS and ECT?
- A TMS induces a controlled seizure; ECT uses magnetic pulses without seizures.
- B TMS is invasive and needs implanted hardware; ECT is fully non-invasive.
- C TMS uses magnetic fields on the awake brain; ECT uses electric current under anesthesia.
- D Both TMS and ECT always require general anesthesia and muscle relaxants.
Correct answer: TMS uses magnetic fields on the awake brain; ECT uses electric current under anesthesia.
TMS uses non-invasive magnetic stimulation in awake patients; ECT uses electrical current to induce a brief seizure under anesthesia.
A nurse is preparing a patient for TMS. Which safety precaution must be verified before starting the session?
- A Confirm the patient has had nothing to eat for the past 24 hours.
- B Ensure no metallic implants are in or near the head (e.g., cochlear).
- C Administer a general anesthetic to sedate the patient first.
- D Place a bite block to prevent jaw injury during the seizure.
Correct answer: Ensure no metallic implants are in or near the head (e.g., cochlear).
Because TMS uses magnetic fields, the presence of metallic implants or devices can pose risk or interference; screening for these is a necessary safety step.
Which of the following is a common nursing teaching point for a patient about to undergo ECT?
- A “You may remain deeply unconscious for about 3 days after the session.”
- B “Your memory will stay perfectly intact with no risk of any loss.”
- C “You may feel groggy and have some short-term memory loss after each treatment.”
- D “You will not be able to take any medications for one month afterward.”
Correct answer: “You may feel groggy and have some short-term memory loss after each treatment.”
Patients should be informed that they may feel drowsy or confused afterwards and might have some short-term memory impairment; this helps with realistic expectations and safety.
Which of the following contraindications should be screened for prior to starting TMS?
- A A documented history of well-controlled mild asthma.
- B Non-removable metallic implants in the head or neck region.
- C Current use of standard antidepressant medications.
- D Being over 65 years of age as the only factor.
Correct answer: Non-removable metallic implants in the head or neck region.
Metallic implants in or near the brain/head/neck may interfere with magnetic fields or pose risk, so TMS screening mandates checking for such implants; the other options are not absolute contraindications.
Which brain stimulation therapy uses a surgically implanted device to send electrical impulses to the vagus nerve and thereby modulate mood?
- A TMS (Transcranial Magnetic Stimulation)
- B ECT (Electroconvulsive Therapy)
- C VNS (Vagus Nerve Stimulation)
- D rTMS (repetitive TMS)
Correct answer: VNS (Vagus Nerve Stimulation)
Vagus Nerve Stimulation (VNS) is a brain stimulation modality involving an implanted device that sends electrical impulses to the vagus nerve; this is distinct from non-invasive TMS or ECT.