Kaplan and Sadocks Synopsis of Psychiatry Test Bank

Correct Answer: A

Rationale: The correct answer is A because offering to dance with the patient shows support, builds trust, and models behavior. This approach can help the shy patient feel more comfortable and encouraged to participate. Choice B focuses on the patient's past experience, which may not directly address the current issue. Choice C isolates the patient, potentially increasing feelings of shyness. Choice D involves a third party, which may not be as effective in building a direct connection with the shy patient. Overall, option A is the most effective in directly engaging and encouraging the shy patient to participate therapeutically in the dance activity group.

Correct Answer: D

Rationale: The correct answer is D, engage in reality-oriented conversation. This is appropriate because it helps the patient ground themselves in reality and potentially reduce the intensity of their delusions. By discussing real-life events and situations, the patient is encouraged to recognize the disparity between their delusional thoughts and actual reality. Choice A is incorrect as simply accepting the delusion as illogical does not actively address the patient's condition. Choice B, distinguishing external boundaries, is not as effective in directly challenging the delusional thoughts. Choice C, explaining the basis for the delusions, may not be helpful initially as the patient may not be receptive to logical explanations due to their distorted thinking.

Correct Answer: B

Rationale: Correct Answer: B (Shock and disbelief) Rationale: 1. The wife's blank stare and statement "It can�t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock. 2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one. 3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation. Summary: A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive. C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief. D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization

Correct Answer: D

Rationale: The correct answer is D because evaluating patient behaviors to reward economic tokens appropriately is a key aspect of behavioral therapy. By assessing and reinforcing positive behaviors with rewards, nurses can encourage patients to continue working towards their therapy goals. Administering medications accurately (choice A) is important but not directly related to behavioral therapy goals. Interacting effectively with the health care team (choice B) is important for overall patient care but does not specifically address behavioral therapy. Being aware of therapeutic modalities (choice C) is important but does not directly contribute to implementing behavioral therapy goals like choice D does.

Correct Answer: D

Rationale: The correct answer is D because volunteering at the local homeless shelter fulfills the self-actualization need in Maslow's hierarchy. By helping others and contributing to the community, the patient gains a sense of purpose and fulfillment, boosting self-esteem. A: Moving to a secure apartment building addresses safety needs, not self-esteem. B: Exercising with friends promotes social belonging but does not directly address self-esteem. C: Attending grandchildren's functions fosters social connections, but it may not directly impact self-esteem like volunteering does.