Kaplan and Sadocks Synopsis of Psychiatry 12th Edition Test Bank

Kaplan and Sadocks Synopsis of Psychiatry 12th Edition Test Bank Related

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A community health nurse visits an elderly person whose spouse died 6 months ago. Two vodka bottles are in the trash. When the nurse asks about alcohol use, this person says, “I get lonely and drink a little to help me forget.” Select the nurse’s most therapeutic intervention.

  • A. Assess whether this patient is drinking and driving.
  • B. Teach the person about risks for alcoholism and suggest other coping strategies
  • C. Advise the person not to drink alone because the risks for injury increase.
  • D. Arrange for the person to attend an Alcoholics Anonymous meeting for older adults.
Correct Answer: B

Rationale: The correct answer is B: Teach the person about risks for alcoholism and suggest other coping strategies. This intervention is the most therapeutic because it addresses the underlying issue of using alcohol as a coping mechanism for loneliness and grief. By educating the person about the risks of alcoholism, the nurse can help the individual understand the potential harm of their current coping strategy. Additionally, suggesting alternative coping strategies can provide healthier ways to deal with loneliness and grief, ultimately promoting better overall well-being.

Choice A is incorrect because while assessing drinking and driving is important, it does not directly address the underlying emotional reasons for the alcohol use.

Choice C is incorrect as it focuses on the risks of injury rather than addressing the emotional aspects of the person's drinking behavior.

Choice D is incorrect as it jumps to a specific intervention without first addressing the person's understanding of their alcohol use and providing alternative coping strategies.

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A patient presents to the emergency department with mixed psychiatric symptoms. The admission nurse suspects the symptoms may be the result of a medical problem. Lab results show elevated BUN (blood urea nitrogen) and creatinine. What is the nurse’s next best action?

  • A. Report the findings to the health care provider.
  • B. Assess the patient for a history of renal problems.
  • C. Assess the patient’s family history for cardiac problems.
  • D. Arrange for the patient’s hospitalization on the psychiatric unit.
Correct Answer: A

Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation.

Summary of Incorrect Choices:
B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues.
C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms.
D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.

A 79-year-old white male tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as:

  • A. Normal pessimism of the elderly.
  • B. A call for sympathy
  • C. Evidence of risks for suicide.
  • D. Normal grieving.
Correct Answer: C

Rationale: The correct answer is C: Evidence of risks for suicide. The statement contains indicators such as feeling very sad, lack of purpose, isolation, and declining health, which are red flags for suicide risk in older adults. It is crucial for healthcare providers to assess and intervene promptly in such cases to prevent harm. Choices A, B, and D are incorrect because they do not address the seriousness of the situation or the potential risk for self-harm.

Which patient behavior supports the diagnosis of residual schizophrenia with negative symptoms?

  • A. Communicating using only rhyming phases
  • B. Claims that worms are crawling in my brain
  • C. Maintaining both arms suspended awkwardly overhead
  • D. Shows no emotion when telling the story of a sister’s recent death
Correct Answer: D

Rationale: The correct answer is D because showing no emotion when discussing a personal tragedy is indicative of blunted affect, a negative symptom commonly seen in residual schizophrenia. This behavior aligns with the diagnostic criteria for residual schizophrenia, which includes the presence of negative symptoms like flat affect. Choices A, B, and C do not directly relate to negative symptoms of schizophrenia. A communicating style or claims about worms do not specifically indicate negative symptoms, and maintaining arms awkwardly overhead is not a typical symptom of residual schizophrenia.

When a novice nurse asks why the unit has a multidisciplinary approach to therapeutic activities, the nurse should explain that multidisciplinary collaboration:

  • A. Reduces the incidence of aggressive behavior by patients
  • B. Produces quicker results and earlier discharge to the community
  • C. Produces better outcomes than when only one perspective is used
  • D. Helps to improve staffing efficiency and resource allocation.
Correct Answer: C

Rationale: Rationale for Correct Answer (C): Multidisciplinary collaboration in therapeutic activities involves the input of professionals from various disciplines, leading to a holistic approach that considers all aspects of a patient's condition. This approach is more likely to result in better outcomes because it combines diverse perspectives, expertise, and skills to address complex patient needs comprehensively.

Summary of Incorrect Choices:
A: Reducing aggressive behavior is not the primary goal of multidisciplinary collaboration in therapeutic activities.
B: While multidisciplinary collaboration may lead to efficient care, the primary focus is on achieving better outcomes rather than quicker discharge.
D: Although improving staffing efficiency and resource allocation may be benefits of multidisciplinary collaboration, the main purpose is to enhance patient care outcomes through diverse perspectives and expertise.

The highest priority for assessment by nurses caring for older adults who self-administer medications is:

  • A. Use of multiple drugs with anticholinergic effects.
  • B. Overuse of medications for erectile dysfunction.
  • C. Missed doses of medications for arthritis.
  • D. Trading medications with acquaintances.
Correct Answer: A

Rationale: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications.

Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects.

Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications.

Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.

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