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

Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.

  • A. Behavioral health home care
  • B. Partial hospitalization
  • C. A skilled nursing facility
  • D. A halfway house
Correct Answer: A

Rationale: The correct answer is A: Behavioral health home care. This option provides ongoing assessment, socialization opportunities, and education about medication and relapse prevention, which are all essential for the elderly patient with major depression. Additionally, it allows the patient to stay in their own home environment, promoting comfort and familiarity.

Option B: Partial hospitalization may not provide the ongoing support and socialization opportunities needed for the patient.

Option C: A skilled nursing facility may offer medical care but may not focus on mental health needs or socialization.

Option D: A halfway house is typically for individuals transitioning from addiction treatment and may not address the specific needs of an elderly patient with major depression.

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A patient attending group therapy mentions, “In the beginning, I was so sick that everyone had to help me. For the last few days, it’s felt good to be able to give something back to the group.” This statement can be assessed as an example of Yalom’s factor of:

  • A. Cohesiveness
  • B. Imitative behavior
  • C. Altruism
  • D. Harmonizing
Correct Answer: C

Rationale: The correct answer is C: Altruism. This statement reflects the concept of altruism in group therapy, as the patient expresses the satisfaction of being able to give back to the group after receiving help in the beginning. Altruism refers to the unselfish concern for the well-being of others. In this case, the patient's experience of feeling good by being able to contribute positively to the group reflects a sense of altruism.
Choices A, B, and D are incorrect:
A: Cohesiveness is the sense of belonging and unity within a group, which is not directly reflected in the patient's statement.
B: Imitative behavior involves mimicking the actions of others, which is not evident in the patient's statement.
D: Harmonizing refers to the process of resolving conflicts and reaching agreement, which is not explicitly mentioned in the patient's statement.

An elderly couple who lived in the same home for the past 50 years have moved into an
adult retirement center in a nearby town. Changes in lifestyle such as this couple is
experiencing should alert the nurse to the possibility of:

  • A. Acute grief
  • B. Traumatic grief
  • C. Chronic sorrow
  • D. Adventitious crisis
Correct Answer: D

Rationale: The correct answer is D: Adventitious crisis. This type of crisis is triggered by external events such as moving to a retirement center after 50 years in the same home. The sudden change in environment can lead to distress and challenges for the elderly couple, causing an adventitious crisis. Acute grief (A) and traumatic grief (B) are typically associated with the loss of a loved one, not a change in lifestyle. Chronic sorrow (C) refers to ongoing grief related to a chronic illness or disability, which is not the case in this scenario.

A teen is grieving the loss of her pet dog. She states to her mother, “I miss my dog so much, but I know that if I start crying, I will never stop.” The teen is expressing a fear of:

  • A. Appearing emotionally immature
  • B. Embarrassing herself by crying in public
  • C. Losing the support of her friends and family.
  • D. Losing control over her emotions.
Correct Answer: D

Rationale: The correct answer is D: Losing control over her emotions. The teen's statement indicates a fear of losing control if she starts crying. This fear suggests that she believes crying will lead to an inability to stop, indicating a concern about managing her emotions. This fear of losing control over her emotions aligns with the teen's hesitance to express her grief through tears.

A: Appearing emotionally immature - This choice is incorrect as the teen's statement does not directly suggest a fear of appearing emotionally immature.
B: Embarrassing herself by crying in public - This choice is incorrect as the teen's statement does not mention a fear of embarrassment.
C: Losing the support of her friends and family - This choice is incorrect as the teen's statement does not indicate a fear of losing support from others.

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.

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.

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