Kaplan and Sadocks Synopsis of Psychiatry Questions

Kaplan and Sadocks Synopsis of Psychiatry Questions Related

Review Kaplan and Sadocks Synopsis of Psychiatry Questions related questions and content

A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient’s needs?

  • A. Skilled nursing facility.
  • B. Adult day care program.
  • C. Partial hospitalization.
  • D. Group home.
Correct Answer: B

Rationale: The correct answer is B: Adult day care program. This option best meets the needs of the patient as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient during the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide activities to stimulate cognitive function.

Explanation of other choices:
A: Skilled nursing facility - Not ideal as the patient does not require 24-hour nursing care.
C: Partial hospitalization - Typically for individuals needing intensive mental health services, not suitable for this patient's needs.
D: Group home - Usually for individuals who need more permanent residential care, not appropriate for the patient's situation.

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A patient states, "I’m not worth anything. I have negative thoughts about myself. I feel anxious and shaky all the time. Sometimes I feel so sad that I want to go to sleep and never wake up." Which nursing intervention should have the highest priority?

  • A. Self-esteem-building activities.
  • B. Anxiety self-control measures.
  • C. Sleep enhancement activities.
  • D. Suicide precautions.
Correct Answer: D

Rationale: The correct answer is D: Suicide precautions. The patient's statement indicates they are experiencing severe depression and suicidal ideation. Suicide precautions should be the highest priority to ensure the patient's safety. This includes removing any potential means of self-harm, constant monitoring, and close supervision. Self-esteem-building activities (A) may be helpful in the long term but are not the immediate priority. Anxiety self-control measures (B) are important but addressing suicidal ideation takes precedence. Sleep enhancement activities (C) are also important but not the highest priority when dealing with suicidal thoughts.

A young woman had just learned of the accidental death of her husband. She begins to cry
and states, Its not fair! How could he do this to me? This remark is assessed as:

  • A. A plea for help
  • B. An explosive episode
  • C. An expression of anger
  • D. Fear of making decisions alone
Correct Answer: C

Rationale: The correct answer is C, an expression of anger. The woman's statement "It's not fair! How could he do this to me?" indicates feelings of anger and resentment towards her husband for leaving her unexpectedly. This response does not show a plea for help (A), as she is expressing her emotions rather than seeking assistance. It is also not an explosive episode (B) as there is no indication of sudden outbursts or intense emotional reactions. Similarly, it is not about fear of making decisions alone (D) as her statement focuses on her feelings of unfairness and betrayal. In summary, the woman's remark reflects her anger and sense of injustice following her husband's accidental death.

Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia. The nurse should follow these steps for this procedure (place in the order they will occur):

  • A. Monitor the patients vital signs before the procedure.
  • B. Medicate as prior to procedure if ordered.
  • C. Educate patient and patients family.
  • D. Check a signed consent
Correct Answer: C

Rationale: Rationale:
1. Educating the patient and family is crucial as it helps alleviate anxiety and ensures informed consent.
2. Monitoring vital signs (A) should be done before, during, and after the procedure, not necessarily in a specific order.
3. Medication administration (B) should be based on physician's orders but is not the initial step.
4. Checking a signed consent (D) is important but typically done before proceeding with any procedure, not necessarily in a specific order.

A novice nurse who will be assessing a patient after electroconvulsive therapy (ECT) asks her mentor, “What sort of memory impairment is present after several ECT treatments?” The best response for the mentor would be:

  • A. “It’s hard to say. Treatment affects everyone differently.”
  • B. “Usually the patient has severe difficulty remembering remote events.”
  • C. “Patients have mild difficulty remembering recent events, like what waseaten for breakfast.”
  • D. “Both recent and remote memory is affected, producing profound confused, cognitive
Correct Answer: D

Rationale: The correct answer is D because it accurately reflects the typical memory impairment after ECT treatments. ECT affects both recent and remote memory, leading to profound confusion and cognitive difficulties. This is due to the disruption of neural pathways involved in memory consolidation and retrieval.

Choice A is incorrect as ECT does have predictable effects on memory. Choice B is incorrect because patients typically have more difficulty with recent memory than remote memory. Choice C is also incorrect as patients usually experience more than just mild difficulty remembering recent events; the memory impairment is more severe than just forgetting what was eaten for breakfast.

The best response to the patient’s statement, "They frobitz me," would be:

  • A. "That’s really too bad that you are being treated that way."
  • B. "Who do you mean when you say everybody?"
  • C. "What difference does frobitzing make?"
  • D. "Why do they frobitz?"
Correct Answer: B

Rationale: The correct answer is B because it seeks clarification and prompts the patient to specify who they are referring to when they say "everybody." This response shows active listening and encourages deeper communication. Choice A offers sympathy but doesn't address the issue directly. Choice C dismisses the significance of "frobitzing." Choice D asks for the reason behind "frobitzing" without seeking clarification on the people involved.

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