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: 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 cwith csupport csystem
d. Frequently cscheduled cone-on-one ctime cwith cnursing cstaff
ANSWER: c D
A ccritical celement cof cpsychotherapeutic cmanagement cis cthe cpresence cof ca ctherapeutic
nurse-patient crelationship. cOne-on-one ctime cwith cnursing cstaff cwill chelp cin cestablishing
cthiscconnection. cWhile cthe cother coptions care cappropriate cand cclient ccentered, cthe cnurse-
client crelation cis ccritical cin cthe c long-term cdelivery cof cquality ceffective ccare cto cthis
cclient.
DIF: Cognitive clevel: cApplying TOP: c Nursing cprocess:
cImplementationcMSC: c Client cNeeds: cPsychosocial cIntegrity
5. A cpatient‘s chaloperidol cdosage cwas creduced c2 cweeks cago cto cdecrease cside ceffects.
cWhat cassessment cquestion cdemonstrates cthe cnurse‘s cunderstanding cof cthe cresulting
cneeds cof cthecclient?
a. ―Will cyou chave cany cdifficulty cgetting c your cprescription crefilled?‖
b. ―Have c you cbegun cexperiencing cany cforms cof challucinations?‖
c. ―What c do cyou cexpect cwill coccur csince cthe cdosage chas cbeen creduced?‖
d. ―What c can cI cdo cto c help c you c manage cthis creduction cin chaloperidol
ctherapy?‖
ANSWER: c B
It cwill cbe cnecessary cfor cthe cnurse cto cassess cfor cexacerbation cof cthe cpatient‘s csymptoms
cof cpsychosis cas cwell cas cfor ca clessening cof cside ceffects. cDosage cdecrease cmight clead cto
cthe creturn cor cworsening cof cpositive csymptoms csuch cas challucinations cand cdelusions,
cand cnegative csymptoms csuch cas cblunted caffect, csocial cwithdrawal, cand cpoor cgrooming.
cWhile cthe cother coptions cmay cbe cappropriate cassessment cquestions, cthey care cnot cdirected
cat cthe ccurrent cneeds cofcthe cclient; cthe cidentification cof cemerging cpsychotic cbehaviors.
DIF: Cognitive clevel: cAnalyzing TOP: c Nursing cprocess:
cAssessmentcMSC: c Client cNeeds: cPhysiologic cIntegrity
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: 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 cwith csupport csystem
d. Frequently cscheduled cone-on-one ctime cwith cnursing cstaff
ANSWER: c D
A ccritical celement cof cpsychotherapeutic cmanagement cis cthe cpresence cof ca ctherapeutic
nurse-patient crelationship. cOne-on-one ctime cwith cnursing cstaff cwill chelp cin cestablishing
cthiscconnection. cWhile cthe cother coptions care cappropriate cand cclient ccentered, cthe cnurse-
client crelation cis ccritical cin cthe c long-term cdelivery cof cquality ceffective ccare cto cthis
cclient.
DIF: Cognitive clevel: cApplying TOP: c Nursing cprocess:
cImplementationcMSC: c Client cNeeds: cPsychosocial cIntegrity
5. A cpatient‘s chaloperidol cdosage cwas creduced c2 cweeks cago cto cdecrease cside ceffects.
cWhat cassessment cquestion cdemonstrates cthe cnurse‘s cunderstanding cof cthe cresulting
cneeds cof cthecclient?
a. ―Will cyou chave cany cdifficulty cgetting c your cprescription crefilled?‖
b. ―Have c you cbegun cexperiencing cany cforms cof challucinations?‖
c. ―What c do cyou cexpect cwill coccur csince cthe cdosage chas cbeen creduced?‖
d. ―What c can cI cdo cto c help c you c manage cthis creduction cin chaloperidol
ctherapy?‖
ANSWER: c B
It cwill cbe cnecessary cfor cthe cnurse cto cassess cfor cexacerbation cof cthe cpatient‘s csymptoms
cof cpsychosis cas cwell cas cfor ca clessening cof cside ceffects. cDosage cdecrease cmight clead cto
cthe creturn cor cworsening cof cpositive csymptoms csuch cas challucinations cand cdelusions,
cand cnegative csymptoms csuch cas cblunted caffect, csocial cwithdrawal, cand cpoor cgrooming.
cWhile cthe cother coptions cmay cbe cappropriate cassessment cquestions, cthey care cnot cdirected
cat cthe ccurrent cneeds cofcthe cclient; cthe cidentification cof cemerging cpsychotic cbehaviors.
DIF: Cognitive clevel: cAnalyzing TOP: c Nursing cprocess:
cAssessmentcMSC: c Client cNeeds: cPhysiologic cIntegrity
