Kaplan and Sadocks Synopsis of Psychiatry Questions

Correct Answer: D

Rationale: The correct answer is D: Suicide precautions. The patient's statement indicates they are experiencing severe depression and suicidal ideation. Suicide precautions should be the highest priority to ensure the patient's safety. This includes removing any potential means of self-harm, constant monitoring, and close supervision. Self-esteem-building activities (A) may be helpful in the long term but are not the immediate priority. Anxiety self-control measures (B) are important but addressing suicidal ideation takes precedence. Sleep enhancement activities (C) are also important but not the highest priority when dealing with suicidal thoughts.

Correct Answer: A

Rationale: The correct answer is A: Implement suicide precautions. This is the highest priority because the patient has a plan for suicide, which poses an immediate risk to their safety. Implementing suicide precautions involves ensuring the patient's environment is safe, removing any potential means of self-harm, and closely monitoring the patient to prevent any suicide attempts. Choice B is incorrect because offering high-calorie snacks and fluids frequently addresses the physical aspect of weight loss but does not address the immediate safety concern of suicide. Choice C is incorrect because assisting the patient to identify personal strengths is important for building self-esteem but is not the highest priority when the patient is at risk for suicide. Choice D is incorrect because observing the patient for therapeutic effects of antidepressant medication is important but not as urgent as ensuring the patient's safety in the case of suicidal ideation.

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.

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.

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.