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TEST BANK - Keltners Psychiatric Nursing, 9th Edition (Steele), Chapters 1 - 36 | All Chapters Complete

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TEST BANK - Keltners Psychiatric Nursing, 9th Edition (Steele), Chapters 1 - 36 | All Chapters Complete 1. A newly licensed asks a nursing recruiter for a description of nursing practice in the psychiatric setting. What is the nurse recruiter‘s best response? a. ―The nurse primarily serves in a supportive role to members of the health care delivery team.‖ b. ―The multidisciplinary approach eliminates the need to clearly define the responsibilities of nursing in such a setting.‖ c. ―Nursing actions are identified by the institution that distinguishes nursing from other mental health professions.‖ d. ―Nursing offers unique contributions to the psychotherapeutic management of psychiatric patients.‖ ANSWER: D Professional role overlap cannot be denied; however, nursing is unique in its focus on and application of psychotherapeutic management. Neither the facility nor the multidisciplinary team define the professional responsibilities of its members but rather utilizes their unique skills to provide holistic care. Ideally, all team members support each other and have functions within the team. DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation MSC: Client Needs: Safe, Effective Care Environment 2. Which component of the nursing process will the nurse focus upon to address the responsibility to match individual patient needs with appropriate services? a. Planning b. Evaluation c. Assessment d. Implementation ANSWER: C Proper assessment is critical for being able to determine the appropriate level of services that will provide optimal care while considering patient input and at the lowest cost. Planning and implementation utilizes the assessment data to identify and execute actions (treatment plan) that will provide appropriate care. Evaluation validates the effectiveness of the treatment plan. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: Client Needs: Safe, Effective Care Environment 3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of effective psychotherapeutic management of this client? a. Discussing the disease process of schizophrenia with the client and their domestic partner b. Minimizing contact between this patient and other patients to assure a stress free milieu c. Administering PRN medication when first observing the evidence that the client may be hallucinating d. Independently determining that behavior modification is appropriate to decrease the client‘s paranoid thoughts ANSWER: A An understanding of psychopathology is the foundation on which the three components of psychotherapeutic management rest; it facilitates therapeutic communication and provides a basis for understanding psychopharmacology and milieu management. Minimizing contact between the patient and others and administering PRN medication indiscriminately are nontherapeutic interventions. Using behavior modification to decrease the frequency of hallucinations would need to be incorporated into the plan of care by the care team. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: Client Needs: Safe, Effective Care Environment 4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which intervention is critical in assuring long-term, effective client care as described by psychotherapeutic management? a. Involvement in group therapies b. Focus of close supervision by the unit staff c. Maintaining effective communication with support system d. Frequently scheduled one-on-one time with nursing staff ANSWER: D A critical element of psychotherapeutic management is the presence of a therapeutic nurse-patient relationship. One-on-one time with nursing staff will help in establishing this connection. While the other options are appropriate and client centered, the nurse-client relation is critical in the long-term delivery of quality effective care to this client. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: Client Needs: Psychosocial Integrity 5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What assessment question demonstrates the nurse‘s understanding of the resulting needs of the client? a. ―Will you have any difficulty getting your prescription refilled?‖ b. ―Have you begun experiencing any forms of hallucinations?‖ c. ―What do you expect will occur since the dosage has been reduced?‖ d. ―What can I do to help you manage this reduction in haloperidol therapy?‖ ANSWER: B It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted affect, social withdrawal, and poor grooming. While the other options may be appropriate assessment questions, they are not directed at the current needs of the client; the identification of emerging psychotic behaviors. DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment MSC: Client Needs: Physiologic Integrity

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TEST BANK
Kellner’s Psychiatric Nursing,

9th Edition (Steele), Chapters 1 - 36 |
All Chapters Complete

,
,Chapter 01: Med, Meds, Milieu
Kellner: Psychiatric Nursing, 8th Edition


MULTIPLE CHOICE

1. A newly licensed asks a nursing recruiter for a description of nursing practice in
the psychiatric setting. What is the nurse recruiter‘s best response?
a. ―The nurse primarily serves in a supportive role to members of the health
care delivery team.‖
b. ―The multidisciplinary approach eliminates the need to clearly define
the responsibilities of nursing in such a setting.‖
c. ―Nursing actions are identified by the institution that distinguishes nursing
from other mental health professions.‖
d. ―Nursing offers unique contributions to the psychotherapeutic management
of psychiatric patients.‖
ANSWE
R: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
application of psychotherapeutic management. Neither the facility nor the multidisciplinary
team define the professional responsibilities of its members but rather utilizes their unique
skills to provide holistic care. Ideally, all team members support each other and have
functions within the team.

DIF: Cognitive level: Analyzing TOP: Nursing process:
Implementation MSC: Client Needs: Safe, Effective Care Environment

2. Which component of the nursing process will the nurse focus upon to address
the responsibility to match individual patient needs with appropriate services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWE
R: C
Proper assessment is critical for being able to determine the appropriate level of services that
will provide optimal care while considering patient input and at the lowest cost. Planning
and implementation utilizes the assessment data to identify and execute actions (treatment
plan) that will provide appropriate care. Evaluation validates the effectiveness of the
treatment plan.

DIF: Cognitive level: Applying TOP: Nursing process:
Assessment MSC: Client Needs: Safe, Effective Care Environment

3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory
hallucinations and walks about the unit, muttering. Which nursing action demonstrates the
nurse‘s understanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their
domestic partner
b. Minimizing contact between this patient and other patients to assure a stress
free milieu

, c. Administering PRN medication when first observing the evidence that the client




May be hallucinating
d. Independently determining that behavior modification is appropriate to decrease
the client‘s paranoid thoughts
ANSWER: A
An understanding of psychopathology is the foundation on which the three components of
psychotherapeutic management rest; it facilitates therapeutic communication and provides a
basis for understanding psychopharmacology and milieu management. Minimizing contact
between the patient and others and administering PRN medication indiscriminately are
nontherapeutic interventions. Using behavior modification to decrease the frequency of
hallucinations would need to be incorporated into the plan of care by the care team.

DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment

4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
intervention is critical in assuring long-term, effective client care as described by
psychotherapeutic management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining effective communication with support system
d. Frequently scheduled one-on-one time with nursing staff
ANSWER: D
A critical element of psychotherapeutic management is the presence of a therapeutic
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this
connection. While the other options are appropriate and client centered, the nurse-client relation
is critical in the long-term delivery of quality effective care to this client.

DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity

5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
assessment question demonstrates the nurse‘s understanding of the resulting needs of the
client?
a. ―Will you have any difficulty getting your prescription refilled? ‖
b. ―Have you begun experiencing any forms of hallucinations? ‖
c. ―What do you expect will occur since the dosage has been reduced? ‖
d. ―What can I do to help you manage this reduction in haloperidol therapy? ‖
ANSWER: B
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or
worsening of positive symptoms such as hallucinations and delusions, and negative symptoms
such as blunted affect, social withdrawal, and poor grooming. While the other options may be
appropriate assessment questions, they are not directed at the current needs of the client; the
identification of emerging psychotic behaviors.

DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity

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