Test Bank For Keltners Psychiatric Nursing, 9th Edition By
Debbie Steele Chapter , All Chapters with Answers and
Rationals
Which behavior demonstrates the most lethal plan by an individual who has recently expressed
suicidal ideations?
a. Driving to the store and buys a bottle of aspirin.
b. Calling his or her therapist threatening to commit suicide.
c. Hoarding a large number of barbiturates
d. Cutting his or her wrists, then calling his or her significant other tosay goodbye. - ANSWER: c.
Hoarding a large number of barbiturates
Patients who have a well-developed plan are considered at increased risk for suicide attempt and
suicide completion. Lethality associated with suicidality is related to accessibility—the means to
commit suicide. Having access to medication with the potential to kill if used to overdose
demonstrates lethality. Self-injury followed by a call to significant other is concerning but not the
most lethal. Neither of the remaining options demonstrate planning that would possibly bring about a
successful suicide.
Which statement made by a severely depressed client reflects the greatest barrier to the nurse's goal
of establishing and maintaining a working client-nurse relationship?
a. "I don't have any idea why I'm so depressed."
b. "I'll talk we you later; I'm too tired right now."
c. "Nobody is really interested in what I have to say."
d. "I don't see what good talking to you will do." - ANSWER: d. "I don't see what good talking to you
will do."
Hopelessness is a major characteristic of severe depression.Withdrawal and disinterest are hallmarks
of the psychopathology of depression and the difficulties in establishing the therapeutic relationship.
While the other statements demonstrate emotions and thoughts associated with hopelessness, none
show a complete lack of interest in developing a relationship to discuss the existing problem
A patient has just completed electroconvulsive therapy. Which intervention is most important for the
nurse to implement?
a. Ask the patient to state his or her name.
b. Monitor the patient's respiratory status.
c. Document the length of the seizure activity.
d. Observe for disorientation. - ANSWER: b. Monitor the patient's respiratory status.
Maintaining a patent airway, monitoring breathing status, and collecting oxygen saturation data
following general anesthesia are a priority. It is important to assess orientation but not most
important, and the patient should be allowed appropriate recovery time before being assessed.
Documentation is important but is not most important at this time.
Which intervention will best address the low self-esteem issues experienced by a middle-aged adult
who has been unemployed for 2 years?
a. Assist the patient in identifying personal skills and achievements.
b. Encourage the patient to focus on retraining opportunities in the community.
c. Listen attentively as the patient retells the details of being unemployed.
d. Provide the patient with a regular bathing and grooming schedule - ANSWER: a. Assist the patient
in identifying personal skills and achievements.
Depressed individuals suffer from low self-esteem. The most effective approach to bolster self-esteem
is to help them focus on the positive(accomplishments, skills, good points). Encouraging good
grooming and problem solving are helpful but have less impact on self-esteem than focusing on the
positive aspects. Attentive listening is important, but caution must be exercised to prevent it from
being a barrier to the patient's plan of care.
, A depressed patient originally responded to a failure by stating, I can't do anything right." Which
statement by the same client would demonstrate the successful implementation of negative thought
programming?
a. "I'm a fairly accomplished cook."
b. "I'll try but I've done this before"
c. "I wish I wasn't so worried about how I look."
d. "I'll look at the want ads and see who's hiring." effective problem solving. - ANSWER: a. "I'm a fairly
accomplished cook."
To learn to rethink the way we view negative situations is referred to as reprogramming negative
thoughts. Making a statement about indicates a skill demonstrates a reframing of the original
negative thought. None of the other options demonstrate a realization that one has skills and talents
and that they can be successful at something.
A patient has been expressing beliefs that are not in touch with reality. The nurse's decision not to
challenge the patient concerning these delusions is based on the understanding that to do so would
bring about what most likely outcome.
a. Undermine the patient's sense of self-worth.
b. Confuse the patient's sense of reality more.
c. Reinforcement of the delusion.
d. Increase the risk of psychotic behavior. - ANSWER: c. Reinforcement of the delusion.
Hallucinations, delusions, or irrational beliefs must never be reinforced. The nurse cannot agree with
the delusions, and arguing seems to reinforce them. The effect of arguing will probably have no effect
on the patient's sense of reality and self-worth. The chance of triggering psychotic behavior is low.
It is most important for the nurse to include the client's significant other when teaching which aspect
of bipolar self-care?
a. The need to notify the health care provider when the client is facing a crisis situation
b. Watching for and reporting impending signs of relapse such as sleeping difficulties and irritability
c. The importance of eating a heart-healthy diet and exercising regularly. d. Receiving credit
counseling in the case the client's behavior has resulted in a large debt - ANSWER: b. Watching for and
reporting impending signs of relapse such as sleeping difficulties and irritability
It is most important to be proactive and to act so as to avoid a crisis situation. The significant others
can assist the patient with self-monitoring and can aid in timely intervention by the health care
professional. Eating well, counseling, and notifying a health care provider are important but do not
take priority in this situation.
Which nursing intervention is likely to be most helpful in providing adequate nutrition while the
patient is experiencing acute mania?
a. Provide nutrient-rich finger foods so the patient can eat while walking and talking.
b. Make food readily available knowing the client will eat when hungry.
c. Offer only liquids that are rich in calories to avoid choking.
d. Insist that the patient join the other patients on the unit during mealtimes. - ANSWER: a. Provide
nutrient-rich finger foods so the patient can eat while walking and talking.
Providing portable, nutrient-rich foods will best support the patient nutritionally during an acute
manic episode, which represents an enormous calorie expenditure. Offering only liquids prevents
intake of whole foods. The patient is often too distracted and busy to eat. Requiring the patient to
join the group at mealtimes is not realistic for a patient in acute mania.
When comparing the needs of patients experiencing depression and those experiencing bipolar
disorder, both groups will require which intervention?
a. Fall and seizure precautions
b. Suicide and escape precautions
c. Careful monitoring of environmental stimuli
d. Assessment of eating and sleeping patterns - ANSWER: d. Assessment of eating and sleeping
patterns
Both groups experience variances in eating and sleeping and will need careful assessments and
monitoring. The depressed patient is not generally in need of escape precautions. Only the manic
Debbie Steele Chapter , All Chapters with Answers and
Rationals
Which behavior demonstrates the most lethal plan by an individual who has recently expressed
suicidal ideations?
a. Driving to the store and buys a bottle of aspirin.
b. Calling his or her therapist threatening to commit suicide.
c. Hoarding a large number of barbiturates
d. Cutting his or her wrists, then calling his or her significant other tosay goodbye. - ANSWER: c.
Hoarding a large number of barbiturates
Patients who have a well-developed plan are considered at increased risk for suicide attempt and
suicide completion. Lethality associated with suicidality is related to accessibility—the means to
commit suicide. Having access to medication with the potential to kill if used to overdose
demonstrates lethality. Self-injury followed by a call to significant other is concerning but not the
most lethal. Neither of the remaining options demonstrate planning that would possibly bring about a
successful suicide.
Which statement made by a severely depressed client reflects the greatest barrier to the nurse's goal
of establishing and maintaining a working client-nurse relationship?
a. "I don't have any idea why I'm so depressed."
b. "I'll talk we you later; I'm too tired right now."
c. "Nobody is really interested in what I have to say."
d. "I don't see what good talking to you will do." - ANSWER: d. "I don't see what good talking to you
will do."
Hopelessness is a major characteristic of severe depression.Withdrawal and disinterest are hallmarks
of the psychopathology of depression and the difficulties in establishing the therapeutic relationship.
While the other statements demonstrate emotions and thoughts associated with hopelessness, none
show a complete lack of interest in developing a relationship to discuss the existing problem
A patient has just completed electroconvulsive therapy. Which intervention is most important for the
nurse to implement?
a. Ask the patient to state his or her name.
b. Monitor the patient's respiratory status.
c. Document the length of the seizure activity.
d. Observe for disorientation. - ANSWER: b. Monitor the patient's respiratory status.
Maintaining a patent airway, monitoring breathing status, and collecting oxygen saturation data
following general anesthesia are a priority. It is important to assess orientation but not most
important, and the patient should be allowed appropriate recovery time before being assessed.
Documentation is important but is not most important at this time.
Which intervention will best address the low self-esteem issues experienced by a middle-aged adult
who has been unemployed for 2 years?
a. Assist the patient in identifying personal skills and achievements.
b. Encourage the patient to focus on retraining opportunities in the community.
c. Listen attentively as the patient retells the details of being unemployed.
d. Provide the patient with a regular bathing and grooming schedule - ANSWER: a. Assist the patient
in identifying personal skills and achievements.
Depressed individuals suffer from low self-esteem. The most effective approach to bolster self-esteem
is to help them focus on the positive(accomplishments, skills, good points). Encouraging good
grooming and problem solving are helpful but have less impact on self-esteem than focusing on the
positive aspects. Attentive listening is important, but caution must be exercised to prevent it from
being a barrier to the patient's plan of care.
, A depressed patient originally responded to a failure by stating, I can't do anything right." Which
statement by the same client would demonstrate the successful implementation of negative thought
programming?
a. "I'm a fairly accomplished cook."
b. "I'll try but I've done this before"
c. "I wish I wasn't so worried about how I look."
d. "I'll look at the want ads and see who's hiring." effective problem solving. - ANSWER: a. "I'm a fairly
accomplished cook."
To learn to rethink the way we view negative situations is referred to as reprogramming negative
thoughts. Making a statement about indicates a skill demonstrates a reframing of the original
negative thought. None of the other options demonstrate a realization that one has skills and talents
and that they can be successful at something.
A patient has been expressing beliefs that are not in touch with reality. The nurse's decision not to
challenge the patient concerning these delusions is based on the understanding that to do so would
bring about what most likely outcome.
a. Undermine the patient's sense of self-worth.
b. Confuse the patient's sense of reality more.
c. Reinforcement of the delusion.
d. Increase the risk of psychotic behavior. - ANSWER: c. Reinforcement of the delusion.
Hallucinations, delusions, or irrational beliefs must never be reinforced. The nurse cannot agree with
the delusions, and arguing seems to reinforce them. The effect of arguing will probably have no effect
on the patient's sense of reality and self-worth. The chance of triggering psychotic behavior is low.
It is most important for the nurse to include the client's significant other when teaching which aspect
of bipolar self-care?
a. The need to notify the health care provider when the client is facing a crisis situation
b. Watching for and reporting impending signs of relapse such as sleeping difficulties and irritability
c. The importance of eating a heart-healthy diet and exercising regularly. d. Receiving credit
counseling in the case the client's behavior has resulted in a large debt - ANSWER: b. Watching for and
reporting impending signs of relapse such as sleeping difficulties and irritability
It is most important to be proactive and to act so as to avoid a crisis situation. The significant others
can assist the patient with self-monitoring and can aid in timely intervention by the health care
professional. Eating well, counseling, and notifying a health care provider are important but do not
take priority in this situation.
Which nursing intervention is likely to be most helpful in providing adequate nutrition while the
patient is experiencing acute mania?
a. Provide nutrient-rich finger foods so the patient can eat while walking and talking.
b. Make food readily available knowing the client will eat when hungry.
c. Offer only liquids that are rich in calories to avoid choking.
d. Insist that the patient join the other patients on the unit during mealtimes. - ANSWER: a. Provide
nutrient-rich finger foods so the patient can eat while walking and talking.
Providing portable, nutrient-rich foods will best support the patient nutritionally during an acute
manic episode, which represents an enormous calorie expenditure. Offering only liquids prevents
intake of whole foods. The patient is often too distracted and busy to eat. Requiring the patient to
join the group at mealtimes is not realistic for a patient in acute mania.
When comparing the needs of patients experiencing depression and those experiencing bipolar
disorder, both groups will require which intervention?
a. Fall and seizure precautions
b. Suicide and escape precautions
c. Careful monitoring of environmental stimuli
d. Assessment of eating and sleeping patterns - ANSWER: d. Assessment of eating and sleeping
patterns
Both groups experience variances in eating and sleeping and will need careful assessments and
monitoring. The depressed patient is not generally in need of escape precautions. Only the manic
