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TEST BANK FOR KELTNERS PSYCHIATRIC NURSING 9TH EDITION BY DEBBIE STEELE CHAPTERS 1-36.
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Test Bank For Keltner’s Psychiatric Nursing 9th Edition By Debbie Steele | | 9780323791960 | Chapter 1- 36 | Complete Questions And Answers A+
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Keltner’s Psychiatric Nursing, 9th Edition Test Bank by Debbie Steele |Chapter 1-36 | All Chapters
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Test Bank For Keltner’s Psychiatric Nursing 9th Edition By Debbie Steele | | 9780323791960 | Chapter 1- 36 | Complete Questions And Answers A+
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TEST BANK FORKELTNERS
PSYCHIATRIC
NURSING 9TH
EDITION BY
DEBBIE STEELE
CHAPTERS 1-36.
Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
,• A newly licensed nurse asks a nursing recruiter for a description of nursing
practice in thepsychiatric 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 clients.‖
ANS: 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
multidisciplinaryteam 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:
ImplementationMSC: Client Needs: Safe, Effective Care Environment
• Which component of the nursing process will the nurse focus upon to
address theresponsibility to match individual client needs with appropriate
services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: C
Proper assessment is critical for being able to determine the appropriate level of
services that will provide optimal care while considering client 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
• An adult diagnosed with paranoid schizophrenia frequently experiences auditory
hallucinations and walks about the unit, muttering. Which nursing action
demonstrates thenurse‘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 client and other clients 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
ANS: A
An understanding of psychopathology is the foundation on which the three
components of psychotherapeutic management rest; it facilitates therapeutic
communication and provides abasis for understanding psychopharmacology and milieu
management. Minimizing contact between the client 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:
ImplementationMSC: Client Needs: Safe, Effective Care Environment
• An adult diagnosed with chronic depression is hospitalized after a suicide attempt.
Whichintervention 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
ANS: D
A critical element of psychotherapeutic management is the presence of a therapeutic
nurse-client relationship. One-on-one time with nursing staff will help in establishing
thisconnection. 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:
ImplementationMSC: Client Needs: Psychosocial Integrity
• A client‘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 theclient?
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?‖
ANS: B
It will be necessary for the nurse to assess for exacerbation of the client‘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 ofthe client which is the identification of emerging psychotic
behaviors.
DIF: Cognitive level: Analyzing TOP: Nursing process:
Assessment MSC: Client Needs: Physiologic Integrity
• Which statement forms the foundation upon which a nurse should base the
implementation ofpsychotherapeutic management to the care of a client with mental
illness?
a. The nurse‘s role in client care is supported by the multidisciplinary team.
b. Omitting any one component will compromise the effectiveness of the treatment.
c. The most important element of psychotherapeutic management is drug therapy.
d. A therapeutic nurse-client relationship is the most important aspect of treatment.
ANS: B
When one element is missing, treatment is usually compromised. No single element is
more important than the others; however, clients‘ needs govern the application of the
componentsand permit judicious use. The remaining options identify components of
the psychotherapeutic management process.
DIF: Cognitive level: Analyzing TOP: Nursing process:
AnalysisMSC: Client Needs: Safe, Effective Care Environment
• Which statement most accurately describes a nurse‘s role regarding
psychopharmacology?
a. ―You will need to frequently make decisions regarding the administration of PRN
medications to help the client manage anger.‖
b. ―It‘s a nursing responsibility to adjust a medication dose to assure effective client
responses.‖
c. ―Nurses administers medications while evaluating drug effectiveness is a medical
responsibility.‖
d. ―To best assure appropriate response, a client‘s questions about drug therapy
should be referred to the psychiatrist.‖
ANS: A
Nursing assessment and analysis of data might suggest the need for PRN medication as
client anxiety increases or psychotic symptoms become more acute. The nurse is the
health team member who makes this determination. Nurses are responsible for
monitoring drug effectiveness as well as administering medication. Nurses should
assume responsibility for teaching clients about the side effects of medications. Nurses
cannot alter prescribed dosagesof medications unless they have prescriptive privileges.
DIF: Cognitive level: Analyzing TOP: Nursing process:
AnalysisMSC: Client Needs: Safe, Effective Care Environment
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