Kaplan and Sadocks Synopsis of Psychiatry Questions

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.

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.

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: 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

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.