Kaplan and Sadocks Synopsis of Psychiatry Test Bank

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: A

Rationale: Correct Answer: A: Gives your agent authority to make decisions during any illness if you are incapacitated. Rationale: 1. A durable power of attorney for health care allows you to appoint a trusted individual (agent) to make medical decisions on your behalf if you are unable to do so. 2. This authority is not limited to a specific type of illness or condition, ensuring your agent can make decisions for any illness that renders you incapacitated. 3. This flexibility ensures that your wishes are carried out regardless of the circumstances. Summary of Other Choices: B: Incorrect - A durable power of attorney can be given to any trusted individual, not just a relative. C: Incorrect - A durable power of attorney can be used in any situation where you are unable to make decisions, not just in terminal illness. D: Incorrect - A durable power of attorney can be implemented immediately upon signing, providing timely decision-making support.

Correct Answer: B

Rationale: The correct answer is B because acute grief typically involves conflicting and unresolved emotions and thoughts related to the loss. The nurse would assess for unresolved issues to provide appropriate support and interventions. Choice A is incorrect as severe depressive symptoms may indicate complicated grief, not typical acute grief. Choice C is incorrect as increased arousal and hypervigilance are more characteristic of post-traumatic stress disorder. Choice D is incorrect as preoccupation with the image of the deceased may be a common experience in grief but does not encompass the full range of emotions and conflicts that acute grief entails.

Correct Answer: A,C

Rationale: The correct answers are A and C. A nurse should evaluate if the older patient can prepare nutritious meals independently, as this indicates their ability to meet basic nutritional needs and maintain independence in daily living. Additionally, assessing if the patient can perform regular, simple maintenance on their primary residence is important for gauging their ability to live safely and comfortably. Choices B and D are incorrect as financial resources and toileting abilities, while important, do not directly reflect functional status in the same way as meal preparation and home maintenance.

Correct Answer: A

Rationale: The correct answer is A: Ambivalence and low self-esteem. The member's statement reflects conflicting emotions (ambivalence) about her worth compared to her husband's. This indicates low self-esteem, as she believes she is less valuable. Unresolved anger (B) would involve blaming her husband, not herself. A need for attention (C) is not evident, as she is sharing personal feelings. Depression (D) may be present, but the statement specifically points to self-deprecation, not just a general feeling of sadness.