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

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

,
,Chapter 01: Med, Meds, Milieu
Keltner: 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.‖
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: ImplementationMSC: Client Needs: Safe, Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to address theres
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ponsibility to match individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C 1


Proper assessment is critical for being able to determine the appropriate level of services that will
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provide optimal care while considering patient input and at the lowest cost. Planning and imple
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mentation utilizes the assessment data to identify and execute actions (treatment plan) that will pr
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ovide appropriate care. Evaluation validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying 1 1


TOP: Nursing process: AssessmentMSC: Client Needs: Safe, Effective C
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are Environment
1




3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinationsa
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nd walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understandi
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ng of effective psychotherapeutic management of this client?
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a. Discussing the disease process of schizophrenia with the client and their domestic
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partner
b. Minimizing contact between this patient and other patients to assure a stress free
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milieu
c. Administering PRN medication when first observing the evidence that the client
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, may be hallucinating1 1


d. Independently determining that behavior modification is appropriate to decrease 1 1 1 1 1 1 1 1


the client‘s paranoid thoughts
1 1 1




ANSWER: A 1


An understanding of psychopathology is the foundation on which the three components of psychot
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herapeutic management rest; it facilitates therapeutic communication and provides abasis for unde
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rstanding psychopharmacology and milieu management. Minimizing contact between the patient
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and others and administering PRN medication indiscriminately are nontherapeutic interventions.
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Using behavior modification to decrease the frequency of hallucinations would need to be incorpo
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rated into the plan of care by the care team.
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DIF: Cognitive level: Applying 1 1


TOP: Nursing process: ImplementationMSC: Client Needs: Safe, Effective C
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are Environment
1




4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Whichint
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ervention is critical in assuring long- 1 1 1 1 1


term, effective client care as described by psychotherapeutic management?
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a. Involvement in group therapies 1 1 1


b. Focus of close supervision by the unit staff
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c. Maintaining effective communication with support system 1 1 1 1 1


d. Frequently scheduled one-on-one time with nursing staff 1 1 1 1 1 1




ANSWER: D 1


A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on- 1 1


one time with nursing staff will help in establishing thisconnection. While the other options are a
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ppropriate and client centered, the nurse-client relation is critical in the long-
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term delivery of quality effective care to this client.
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DIF: Cognitive level: Applying 1 1


TOP: Nursing process: ImplementationMSC: Client Needs: Psychosocial Inte
1 1 1 1 1 1 1 1


grity

5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What ass
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essment question demonstrates the nurse‘s understanding of the resulting needs of theclient
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?
a. ―Will you have any difficulty getting your prescription refilled?‖
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b. ―Have you begun experiencing any forms of hallucinations?‖
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c. ―What do you expect will occur since the dosage has been reduced?‖
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d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
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ANSWER: B 1


It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychos
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is as well as for a lessening of side effects. Dosage decrease might lead to the return or worsenin
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g of positive symptoms such as hallucinations and delusions, and negative symptoms such as bl
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unted affect, social withdrawal, and poor grooming. While the other options may be appropriate
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assessment questions, they are not directed at the current needs ofthe client; the identification of
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emerging psychotic behaviors. 1 1




DIF: Cognitive level: Analyzing 1 1


TOP: Nursing process: AssessmentMSC: Client Needs: Physiologic Integ
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rity