Kaplan and Sadocks Synopsis of Psychiatry Questions

Kaplan and Sadocks Synopsis of Psychiatry Questions Related

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A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT, a nurse should recognize the continued need for which critical intervention?

  • A. Suicide assessment must continue throughout the ECT course.
  • B. Antidepressant medications are contraindicated throughout the ECT course.
  • C. Discourage expressions of hopelessness throughout the ECT course.
  • D. Encourage a high-caloric diet throughout the ECT course.
Correct Answer: A

Rationale: The correct answer is A because suicide assessment must continue throughout the ECT course to ensure the safety and well-being of the client. During ECT, the client may experience changes in mood and behavior, which could impact their risk of suicide. It is essential for the nurse to monitor and assess the client's suicidal ideation and intent regularly. This ongoing assessment helps in identifying any exacerbation of suicidal thoughts and allows for timely intervention to prevent self-harm.

Choice B is incorrect because antidepressant medications are not necessarily contraindicated throughout the ECT course. In some cases, a client may still require antidepressants in addition to ECT for optimal treatment outcomes.

Choice C is incorrect because it is important to acknowledge and validate the client's feelings of hopelessness rather than discouraging them. By addressing and exploring these feelings, the nurse can provide support and facilitate the client's emotional processing.

Choice D is incorrect because encouraging a high-caloric diet is not directly related to the critical intervention needed during

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When a patient asks the nurse, “How can jolting me with an electrical shock possibly do me any good?” the answer most reflective of current biologic theory would be:

  • A. “ECT produces a change in brain chemistry that results in improved mood.
  • B. “ECT provides you with external punishment so you can stop punishing yourself.”
  • C. “ECT interrupts brain impulses that are causing hallucinations and delusions.”
  • D. ECT shocks the brain into re-establishing normal electrical patterns.”
Correct Answer: A

Rationale: Step 1: Electroconvulsive therapy (ECT) is a treatment for severe depression and other mental health disorders.
Step 2: Current biological theory suggests that ECT produces changes in brain chemistry, specifically neurotransmitters, leading to improved mood.
Step 3: The correct answer (A) aligns with this theory by explaining how ECT impacts brain chemistry to alleviate symptoms.
Step 4: Answer B is incorrect as ECT is not used as punishment but as a therapeutic intervention.
Step 5: Answer C is incorrect as ECT is not primarily used to interrupt brain impulses causing hallucinations and delusions.
Step 6: Answer D is incorrect as ECT does not shock the brain into re-establishing normal electrical patterns but rather affects neurotransmitter levels.

When differentiating between bereavement symptoms and depression, the nurse will base the formulation on knowledge that in bereavement:

  • A. Symptoms remit and exacerbate.
  • B. Guilt feelings are overwhelming.
  • C. Suicide thoughts are common.
  • D. Psychomotor retardation is obvious.
Correct Answer: A

Rationale: The correct answer is A because in bereavement, symptoms of grief and sadness tend to come and go, known as remitting and exacerbating, as the individual processes the loss over time. This is a normal part of the grieving process. On the other hand, in depression, symptoms are persistent and may not improve without intervention. Guilt feelings being overwhelming (B) is common in both bereavement and depression. Suicide thoughts being common (C) can occur in severe depression but are not a distinguishing factor between bereavement and depression. Psychomotor retardation being obvious (D) is a symptom more commonly associated with severe depression rather than bereavement.

Which nursing intervention supports the principles on which the cross-links theory of aging is based?


  • A. Applying an elastin-sustaining moisturizer to an adult patient’s skin
  • B. Assessing a patient’s family history for genetic diseases and disorders
  • C. Questioning a patient about long-term exposure to environmental toxins
  • D. Assisting an adult patient in selecting foods high in vitamins A, C, and E
Correct Answer: D

Rationale: The correct answer is D because selecting foods high in vitamins A, C, and E supports the principles of the cross-links theory of aging, which focuses on the accumulation of damage from oxidative stress. Vitamins A, C, and E are antioxidants that help combat oxidative stress and reduce the formation of cross-links in tissues. This intervention can potentially slow down the aging process by reducing cellular damage.

Choice A is incorrect because applying an elastin-sustaining moisturizer does not directly address the oxidative stress aspect of the cross-links theory of aging.

Choice B is incorrect as assessing family history for genetic diseases does not specifically target the mechanisms involved in the cross-links theory of aging.

Choice C is incorrect because questioning about exposure to environmental toxins may be important for overall health but is not directly related to the principles of the cross-links theory of aging.

Which intervention should the nurse plan to reduce the patient's focus on delusional thinking?

  • A. Confronting the delusion
  • B. Refuting the delusion with logic
  • C. Exploring reasons the patient has the delusion
  • D. Focusing on feelings suggested by the delusion
Correct Answer: D

Rationale: The correct answer is D because focusing on the feelings suggested by the delusion can help the patient process and manage their emotions underlying the delusion. By addressing the emotions, the nurse can help the patient gain insight into the delusion and reduce its intensity. Confronting the delusion (A) may lead to resistance and reinforcement. Refuting the delusion with logic (B) may further alienate the patient. Exploring reasons for the delusion (C) may not directly address the emotional component.

When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?

  • A. Evidence of spasticity or flaccidity
  • B. The patient’s level of motor activity
  • C. Medications the patient has recently taken
  • D. Level of preoccupation with somatic symptoms
Correct Answer: C

Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause symptoms of delirium or exacerbate confusion in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced causes of confusion and adjust the treatment accordingly.

Choice A (Evidence of spasticity or flaccidity) is incorrect because these symptoms are more related to neurological conditions such as stroke or spinal cord injury, not specifically delirium.

Choice B (The patient’s level of motor activity) is not as relevant in distinguishing delirium from other problems as medication history, as motor activity can be influenced by various factors.

Choice D (Level of preoccupation with somatic symptoms) is also less relevant compared to medication history in differentiating delirium, as somatic symptoms may not always directly indicate the underlying cause of confusion in elderly patients.

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