Kaplan and Sadocks Synopsis of Psychiatry Questions

Kaplan and Sadocks Synopsis of Psychiatry Questions Related

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A patient is scheduled to attend an occupational therapy group to work on the identified goal of “recognizing and using more effective coping techniques.” What measure can the nurse use to continue to support the patient’s attainment of this goal after he returns to the unit?

  • A. Praising him for positive behavioral changes
  • B. Avoiding setting limits that would increase his anxiety level
  • C. Isolating him from more seriously ill patients
  • D. Recommending that he avoid group activities for a while
Correct Answer: A

Rationale: The correct answer is A: Praising him for positive behavioral changes. This measure reinforces the patient's use of effective coping techniques, providing positive feedback and motivation. This positive reinforcement encourages the patient to continue utilizing these strategies.

Choices B, C, and D are incorrect:
B: Avoiding setting limits that would increase his anxiety level - This does not actively support the patient's goal of recognizing and using more effective coping techniques.
C: Isolating him from more seriously ill patients - Isolation does not promote the practice of coping techniques and may hinder the patient's social interaction and progress.
D: Recommending that he avoid group activities for a while - Avoiding group activities contradicts the goal of attending occupational therapy groups and working towards improved coping techniques.

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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.

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.

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.

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.

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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