Synopsis of Psychiatry Test Bank

Correct Answer: B

Rationale: Children often express anxiety through physical complaints like stomachaches, especially in situations that cause distress or discomfort, such as visiting a noncustodial parent.

Correct Answer: D

Rationale: A therapeutic milieu is characterized by focusing on the needs and goals of the patients. By establishing specific patient-centered goals that are agreed upon mutually by the patient and the staff, it ensures that the care provided is individualized and tailored to the patient's needs. This approach fosters a collaborative and empowering environment where the patient feels heard and supported in their recovery journey. It also promotes a sense of ownership and accountability for both the patient and the staff in working towards these goals together. In contrast, rigid adherence to timelines and unit routine (option A) may not always take into account the unique needs of each patient, and relaxation of boundaries (option B) can potentially compromise the therapeutic process by blurring professional boundaries. Therefore, establishing patient-centered goals is a key component of creating a therapeutic environment on a nursing unit.

Correct Answer: D

Rationale: Glycopyrrolate is an anticholinergic that reduces salivation and other secretions, which helps to prevent aspiration during ECT, where muscle relaxants are used.

Correct Answer: C

Rationale: Depression and suicide are serious concerns for elderly individuals and should be prioritized in education for caregivers to ensure early identification and intervention.

Correct Answer: D

Rationale: The nurse is most likely to need to schedule a pre-electroconvulsive therapy (ECT) workup and teaching for Patient D, who has depression associated with the diagnosis of an inoperable brain tumor. In such cases, ECT may be considered as a treatment option due to the severity of the depression and the limitations in using other treatments. Before ECT can be initiated in a patient with such complex medical conditions, it is crucial to conduct a thorough evaluation and preparation process, which includes obtaining informed consent, assessing the patient's medical history, conducting pre-ECT laboratory tests, and providing patient and family education about the procedure. Given the unique circumstances of Patient D's inoperable brain tumor, the nurse must ensure all necessary steps are taken to ensure the safety and efficacy of ECT as a treatment option.