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

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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An 85-year-old patient is admitted to the hospital with the diagnosis of cerebrovascular accident and depression. The symptom that is unrelated to depression would be?

  • A. Crying and refusing to perform task
  • B. Answering I forgot to questions
  • C. Having positive self-esteem
  • D. Neglecting ADLs
Correct Answer: C

Rationale: The correct answer is C: Having positive self-esteem. This is unrelated to depression as depression typically involves feelings of worthlessness and low self-esteem. A: Crying and refusing tasks, B: Answering "I forgot to" questions, and D: Neglecting ADLs are all commonly associated symptoms of depression such as apathy, memory issues, and lack of motivation for self-care. Therefore, choice C stands out as the symptom unrelated to depression due to its contradiction with the typical manifestations of the condition.

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.

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.

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.

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.

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