Synopsis of Psychiatry Test Bank

Correct Answer: B

Rationale: Operant conditioning, based on Skinner�s theory, involves reinforcing desired behaviors. Positive reinforcement (praise) encourages repetition of the behavior.

Correct Answer: B

Rationale: The patient's behavior of smiling and remaining in control while refusing support from friends, despite attending a service memorializing his wife's death, is indicative of distorted grief. In distorted grief, individuals may show seemingly inappropriate reactions or behaviors that do not align with the typical grieving process. The patient's avoidance of accepting support and expression of excessive self-reliance in the face of a significant loss suggest a distorted way of coping with grief. In normal grief, individuals may experience a range of emotions and accept support from others as they navigate through the grieving process.

Correct Answer: D

Rationale: Group therapy is important because psychopathology often has its roots in disordered relationships. Many mental health issues are influenced by one's interactions with others, whether it be issues with communication, trust, boundaries, or other relational dynamics. Group therapy provides a structured environment where patients can explore and work through these relational difficulties with the support and feedback of peers. By addressing these relational patterns in a group setting, patients can gain insight into their behavior and develop healthier ways of relating to others. This can be a valuable component of their overall treatment plan and can help facilitate lasting change and growth.

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.

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.