An 85-year-old patient is admitted to the hospital with the diagnosis of cerebrovascular accident and depression. The symptom that is unrelated to depression would be?

Questions 29

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Kaplan and Sadocks Synopsis of Psychiatry Questions Questions

Question 1 of 9

An 85-year-old patient is admitted to the hospital with the diagnosis of cerebrovascular accident and depression. The symptom that is unrelated to depression would be?

Correct Answer: C

Rationale: The correct answer is C: Having positive self-esteem. This is unrelated to depression as depression typically involves feelings of worthlessness and low self-esteem. A: Crying and refusing tasks, B: Answering "I forgot to" questions, and D: Neglecting ADLs are all commonly associated symptoms of depression such as apathy, memory issues, and lack of motivation for self-care. Therefore, choice C stands out as the symptom unrelated to depression due to its contradiction with the typical manifestations of the condition.

Question 2 of 9

Which intervention should the nurse plan to reduce the patient's focus on delusional thinking?

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.

Question 3 of 9

A woman whose abusive husband was killed in an automobile accident 3 years earlier continues to idealize him and repeatedly talks about their “wonderful relationship.” Which outcome is most appropriate for the patient? Patient will:

Correct Answer: C

Rationale: Rationale: Choice C is correct because it encourages the patient to express both positive and negative feelings about her husband and their relationship. This approach helps the patient process complex emotions and move towards a more realistic view of the past. It promotes emotional healing and growth by allowing the patient to acknowledge and work through conflicting feelings. Summary of Incorrect Choices: A: While emotional support is important, simply enlisting the support of family and friends may not address the underlying issues of idealization and unresolved emotions. B: Keeping a daily journal may reinforce the idealization of the husband and could potentially hinder the patient's progress in coming to terms with the reality of the relationship. D: Reading about abuse and support groups may provide information, but it does not directly address the patient's need to explore and express her own feelings about her husband and their relationship.

Question 4 of 9

The wife of a patient diagnosed with paranoid schizophrenia asks: “I’ve been told that my husband’s illness is probably related to imbalanced brain chemicals. Can you be more specific?”

Correct Answer: C

Rationale: The correct answer is C: An increase in the brain chemical dopamine explains the presence of delusions and hallucinations. In paranoid schizophrenia, there is an overactivity of dopamine receptors in the brain, leading to an excess of dopamine. This excess dopamine is associated with symptoms like delusions and hallucinations. Therefore, an increase in dopamine levels is directly linked to these specific symptoms in individuals with paranoid schizophrenia. Explanation for why the other choices are incorrect: A: Breakdown of dopamine producing LSD does not directly relate to the symptoms of paranoid schizophrenia. B: Decreased amounts of dopamine do not explain the presence of delusions and hallucinations in paranoid schizophrenia; it is the increase in dopamine that is associated with these symptoms. D: An increase in dopamine is more closely related to delusions and hallucinations rather than lack of motivation and disordered affect in paranoid schizophrenia.

Question 5 of 9

A patient states, "I’m not worth anything. I have negative thoughts about myself. I feel anxious and shaky all the time. Sometimes I feel so sad that I want to go to sleep and never wake up." Which nursing intervention should have the highest priority?

Correct Answer: D

Rationale: The correct answer is D: Suicide precautions. The patient's statement indicates they are experiencing severe depression and suicidal ideation. Suicide precautions should be the highest priority to ensure the patient's safety. This includes removing any potential means of self-harm, constant monitoring, and close supervision. Self-esteem-building activities (A) may be helpful in the long term but are not the immediate priority. Anxiety self-control measures (B) are important but addressing suicidal ideation takes precedence. Sleep enhancement activities (C) are also important but not the highest priority when dealing with suicidal thoughts.

Question 6 of 9

A young woman had just learned of the accidental death of her husband. She begins to cry and states, Its not fair! How could he do this to me? This remark is assessed as:

Correct Answer: C

Rationale: The correct answer is C, an expression of anger. The woman's statement "It's not fair! How could he do this to me?" indicates feelings of anger and resentment towards her husband for leaving her unexpectedly. This response does not show a plea for help (A), as she is expressing her emotions rather than seeking assistance. It is also not an explosive episode (B) as there is no indication of sudden outbursts or intense emotional reactions. Similarly, it is not about fear of making decisions alone (D) as her statement focuses on her feelings of unfairness and betrayal. In summary, the woman's remark reflects her anger and sense of injustice following her husband's accidental death.

Question 7 of 9

Which description is characteristic of an impulsive child?

Correct Answer: A

Rationale: The correct answer is A. An impulsive child typically acts without thinking or considering consequences, such as running into the street without looking. This behavior is impulsive, risky, and disregards safety instructions. Choices B and C describe behaviors that are more indicative of other issues like hyperactivity or hallucinations. Choice D suggests difficulty concentrating, which is not directly related to impulsivity. In summary, the key characteristic of an impulsive child is acting quickly without considering potential dangers or instructions.

Question 8 of 9

A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient’s needs?

Correct Answer: B

Rationale: The correct answer is B: Adult day care program. This option best meets the needs of the patient as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient during the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide activities to stimulate cognitive function. Explanation of other choices: A: Skilled nursing facility - Not ideal as the patient does not require 24-hour nursing care. C: Partial hospitalization - Typically for individuals needing intensive mental health services, not suitable for this patient's needs. D: Group home - Usually for individuals who need more permanent residential care, not appropriate for the patient's situation.

Question 9 of 9

Which person has the greatest potential for developing dysfunctional grief?

Correct Answer: C

Rationale: The correct answer is C because sudden, traumatic deaths can lead to complicated grief reactions. This type of loss can disrupt the individual's ability to process and accept the death, resulting in prolonged and intense emotional distress. The other choices, A, B, and D, do not inherently indicate a higher potential for dysfunctional grief as they do not involve the same level of suddenness or trauma. Teen popularity, expressing love for a deceased spouse, and experiencing multiple losses over time are common situations that may not necessarily lead to dysfunctional grief if appropriate support and coping mechanisms are in place.

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