Kaplan and Sadocks Synopsis of Psychiatry Questions

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.

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.

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.

Correct Answer: C

Rationale: The correct answer is C, an expression of anger. The woman's statement "It's not fair! How could he do this to me?" indicates feelings of anger and resentment towards her husband for leaving her unexpectedly. This response does not show a plea for help (A), as she is expressing her emotions rather than seeking assistance. It is also not an explosive episode (B) as there is no indication of sudden outbursts or intense emotional reactions. Similarly, it is not about fear of making decisions alone (D) as her statement focuses on her feelings of unfairness and betrayal. In summary, the woman's remark reflects her anger and sense of injustice following her husband's accidental death.

Correct Answer: A

Rationale: The correct answer is A because suicide assessment must continue throughout the ECT course to ensure the safety and well-being of the client. During ECT, the client may experience changes in mood and behavior, which could impact their risk of suicide. It is essential for the nurse to monitor and assess the client's suicidal ideation and intent regularly. This ongoing assessment helps in identifying any exacerbation of suicidal thoughts and allows for timely intervention to prevent self-harm. Choice B is incorrect because antidepressant medications are not necessarily contraindicated throughout the ECT course. In some cases, a client may still require antidepressants in addition to ECT for optimal treatment outcomes. Choice C is incorrect because it is important to acknowledge and validate the client's feelings of hopelessness rather than discouraging them. By addressing and exploring these feelings, the nurse can provide support and facilitate the client's emotional processing. Choice D is incorrect because encouraging a high-caloric diet is not directly related to the critical intervention needed during