During a grief-processing group, an elderly patient stated, “For the first time since my husband died, I’m having more good days than bad.” This statement suggests that the patient has:

Questions 29

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Kaplan and Sadocks Synopsis of Psychiatry Test Bank Questions

Question 1 of 9

During a grief-processing group, an elderly patient stated, “For the first time since my husband died, I’m having more good days than bad.” This statement suggests that the patient has:

Correct Answer: C

Rationale: The correct answer is C: Completed her "grief work" successfully. This statement indicates progress in the grieving process, moving towards acceptance and healing. The patient acknowledging having more good days than bad reflects a positive shift in coping with the loss, indicating that she has processed her grief and is beginning to adapt to life without her husband. This suggests that the patient has worked through her emotions, memories, and adjustments related to the loss, reaching a point where she is experiencing more peace and acceptance. Summary: A: Reestablishment is not the correct choice as it does not specifically address the completion of the grief work. B: Determining readiness to terminate the support group is premature, as the patient may still benefit from continued support. D: Replacing old memories with new ones is not supported by the patient's statement and does not necessarily indicate successful grief processing.

Question 2 of 9

Which initial short-term outcome would be appropriate for a patient admitted with delusional thoughts?

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.

Question 3 of 9

Which statement made by a patient just prior to being transported for a scheduled ECT treatment would result in cancellation of the treatment?

Correct Answer: A

Rationale: The correct answer is A because asking about memory loss indicates a lack of informed consent and understanding of ECT procedure. Memory loss is a common side effect of ECT, and a patient should be well-informed about it before treatment. Choices B, C, and D do not raise concerns about the patient's understanding or readiness for ECT, making them incorrect. Choice B asks about dietary concerns, which do not directly impact the treatment. Choice C shows the patient's hope for improvement, which is a positive attitude. Choice D indicates the patient's desire for more information, which is a sign of engagement in their care.

Question 4 of 9

During the first family therapy session, the mother of a child being treated for truancy and emotional outbursts asks the nurse, “Why are you bothering to ask the rest of us questions? My son is the one with the problems.” The best response for the nurse would be:

Correct Answer: A

Rationale: The correct answer is A because involving the entire family in therapy sessions allows for a more comprehensive understanding of the family dynamics and how they may be contributing to the child's issues. By including all family members, the nurse can gather diverse perspectives and insights that can inform the treatment plan. This approach also promotes family unity and collaboration in addressing the child's problems. Option B is not the best response as it lacks a clear rationale for involving the whole family. Option C, while partially true, does not directly address the question raised by the mother. Option D emphasizes the importance of every family member's perceptions but does not specifically address the benefits of involving the entire family in therapy sessions.

Question 5 of 9

Which statement best explains how a mother of several children should prepare to help them cope with the loss of a dear aunt?

Correct Answer: A

Rationale: The correct answer is A because each child will indeed grieve in a unique way and on their own timetable. This approach recognizes the individuality of each child's emotions and coping mechanisms. By understanding and respecting their differences, the mother can provide tailored support and comfort. Option B oversimplifies the grieving process and ignores the complexity of individual responses. Option C generalizes the stages of grief for all people and does not account for variations in how children may process loss. Option D incorrectly suggests that extreme reactions are more common in young children, which is not necessarily true as grief responses can vary widely among children.

Question 6 of 9

A teenage boy has lost his best friend as a result of a hunting accident. His parents report that he is eating and sleeping very little and expresses little interest in school. They are concerned that he talks about the accident repeatedly. These behaviors are generally seen as:

Correct Answer: C

Rationale: The correct answer is C: Expressions of a normal grief reaction. The teenage boy's behaviors of poor appetite, insomnia, lack of interest in school, and repetitive discussions about the accident are common manifestations of grief. This grief reaction is a normal response to losing a close friend in a traumatic manner like a hunting accident. It is important to acknowledge and validate his emotions during this difficult time. Incorrect Choices: A: Expressing responsibility for his friend's death - This choice suggests guilt or blame on the part of the boy, which is not evident in the scenario. B: Attempts to avoid dealing with his pain - The boy's behaviors indicate he is processing his grief rather than avoiding it. D: Indications of a risk for self-harm - While it is important to monitor for signs of self-harm, the behaviors described are more indicative of grief rather than immediate self-harm risk.

Question 7 of 9

A grief support group is held at the local community center to assist persons who are dealing with issues of loss. Which remark by one of the members would the nurse interpret as indicating unresolved feelings of guilt?

Correct Answer: C

Rationale: The correct answer is C because the statement indicates feelings of guilt about not getting help sooner, suggesting the member may blame themselves for the loss. This remark reflects a sense of responsibility and regret, common in unresolved guilt. Choice A expresses acceptance, B reflects natural grief progression, and D highlights difficulty during specific times, not necessarily linked to guilt. By analyzing the content of each statement, the nurse can identify cues related to unresolved feelings of guilt.

Question 8 of 9

After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?

Correct Answer: C

Rationale: The correct answer is C. It acknowledges the client's autonomy while also addressing their concerns. First, it recognizes the client's right to discontinue treatment. Second, it opens the door for a discussion to explore the client's worries and provide support. This response shows empathy and respects the client's decision-making. Choice A is incorrect because it dismisses the client's autonomy and fails to address their concerns. Choice B is not as appropriate as it suggests only talking to the doctor, missing the opportunity for the nurse to provide immediate support. Choice D is incorrect as it invalidates the client's experience of memory loss and fails to address their concerns.

Question 9 of 9

When a hospitalized patient dies, his wife stares blankly and states, "It can’t be." This indicates:

Correct Answer: B

Rationale: Correct Answer: B (Shock and disbelief) Rationale: 1. The wife's blank stare and statement "It can’t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock. 2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one. 3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation. Summary: A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive. C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief. D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization

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