Psychiatric Nursing 7th Edition Keltner Test Bank.pdf

TB Psychiatric Nursing 7th Edition by Keltner Norman & Steele Debbie. ISBN
g g g g g g g g g g g

9780323185790
g



Chapter 1-36
g




Chapter 01: Me, Meds, Milieu
g g g g




MULTIPLEgCHOICE

1. Selectgthegbestgdescriptiongofgnursinggpracticegingthegpsychiatricgsetting.
a. Thegnursegprimarilygservesgingagsupportivegrolegtogothergmembersgofgthegteam.
b. Thegmultidisciplinarygapproachgeliminatesgthegneedgtogclearlygdefinegthe
responsibilitiesgofgnursing.
c. Clearlygdifferentiatedgnursinggactionsghavegbeengidentifiedgthatgdistinguishgnursing
fromgothergprofessions.
d. Althoughgprofessionalgrolegoverlapgexists,gnursinggoffersguniquegcontributionsgto
psychotherapeuticgmanagement.
ANS:g D
Professionalgrolegoverlapgcannotgbegdenied;ghowever,gnursinggisguniquegingitsgfocusgongandgappli
cationgofgpsychotherapeuticgmanagement.gPsychiatricgsocialgworkersgdognotghavegexpertisegingp
hysicalgcare.gIdeally,gallgteamgmembersgsupportgeachgother.

DIF: Cognitiveglevel:gApplying REF:g g p.g3
TOP:g Nursinggprocess:gImplementation MSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

2. Thegprimarygelementgrequiredgtogmatchgindividualgpatientgneedsgwithgappropriategservicesgisg
proper:
a. planning.
b. evaluation.
c. assessment.
d. implementation.
ANS:g C
Propergassessmentgisgcriticalgforgbeinggablegtogdeterminegthegappropriateglevelgofgservicesgthatgw
illgprovidegthegpatientgwithgoptimalgcaregatgtheglowestgcost.gThegdecisiongtreegforgthegcontinuumg
ofgcaregestablishesgthisgfact.

DIF: Cognitiveglevel:gUnderstanding REF:g g p.g7
TOP:g Nursinggprocess:gAssessment MSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

3. Angadultgwithgparanoidgschizophreniagisghospitalized.gThisgpatientghasgfrequentgauditoryghal
lucinationsgandgwalksgaboutgthegunit,gmuttering.gTogusegpsychotherapeuticgmanagementgeffe
ctively,gitgisgmostgimportantgforgthegnursegto:
a. understandgthegdiseasegprocessgofgschizophrenia.
b. minimizegcontactgbetweengthisgpatientgandgothergpatients.
c. administergPRNgmedicationgbeforeginteractinggwithgthegpatient.
d. usegbehaviorgmodificationgtogdecreasegthegfrequencygofghallucinations.
ANS:g A

, Angunderstandinggofgpsychopathologygisgthegfoundationgongwhichgthegthreegcomponentsgofgpsy
chotherapeuticgmanagementgrest;gitgfacilitatesgtherapeuticgcommunicationgandgprovidesgagbasisg
forgunderstandinggpsychopharmacologygandgmilieugmanagement.gMinimizinggcontactgbetween
gthegpatientgandgothersgandgadministeringgPRNgmedicationgindiscriminatelygaregnontherapeuticg

interventions.gUsinggbehaviorgmodificationgtogdecreasegthegfrequencygofghallucinationsgwouldg
needgtogbegincorporatedgintogthegplangofgcare.

DIF: Cognitiveglevel:gApplying REF:g g pp.g1-2
TOP:g Nursinggprocess:gImplementation MSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

4. Agdepressedgadultgisghospitalizedgaftergagsuicidegattempt.gThegpatientgreceivesgangantidepre
ssantgmedication,gisgcloselygsupervised,gattendsgagvarietygofggroupgtherapiesgandgactivities,g
watchesgtelevisiongduringgfreegtime,gandgtalksgtogvisitorsgingthegevening.gWhichgadditionalgi
nterventiongisgneededgingthegpatient‘sgcare?
a. Milieugtherapy
b. Adequategdruggtherapy
c. Increasedgcontactgwithgsignificantgothers
d. Meaningfulgcommunicationgwithgnursinggstaff
ANS:g D
Twogofgthegthreegelementsgofgpsychotherapeuticgmanagementgaregpresent:gpsychopharmacolog
ygandgmilieugmanagement.gTheregisgnogevidencegthatgthegpsychotherapeuticgnurse–
patientgrelationshipgexists.gMaintaininggcontactgwithgsignificantgothersgisgnotgconsideredgangele
mentgofgthegpsychotherapeuticgmanagementgmodel.

DIF: Cognitiveglevel:gApplying REF:g pp.g1-2
TOP:g Nursinggprocess:gPlanninggMSC:g NCLEX:gPsychosocialgIntegrity

5. Agpatientgattendsgoutpatientgprogramsgatgagcommunitygmentalghealthgcentergandgmeetsgwithgthegp
rimarygnursegregularly.gLastgweek,gthegpatient‘sghaloperidolg(Haldol)gdosegwasgreducedgfromg5g
mggtog2gmggdailygtogdecreasegsidegeffects.gThegnursegwillgneedgtogmonitorgchangesgin:
a. thegactivitygschedulegatgthegcenter.
b. thegnaturegofgthegpatient‘sgsymptoms.
c. attentionggivengtogthegpatientgbygothergstaff.
d. balancegamonggpsychotherapeuticgmanagementgelements.
ANS:g B
Itgwillgbegnecessarygforgthegnursegtogassessgforgexacerbationgofgthegpatient‘sgsymptomsgofgpsych
osisgasgwellgasgforgangameliorationgofgsidegeffects.gDosagegdecreasegmightgleadgtogthegreturngorg
worseninggofgpositivegsymptomsgsuchgasghallucinationsgandgdelusions,gandgnegativegsymptomsg
suchgasgbluntedgaffect,gsocialgwithdrawal,gandgpoorggrooming.

DIF: Cognitiveglevel:gApplying REF:g g p.g2
TOP:g Nursinggprocess:gAssessment MSC:g NCLEX:gPhysiologicgIntegrity

6. Whichgguidelinegshouldgagnursegusegwhengapplyinggthegcomponentsgofgpsychotherapeuticg
managementgtogthegcaregofgagpatientgwithgmentalgillness?
a. Thegnurse‘sgrolegingmilieugmanagementgisgsecondarygtogthatgofgsocialgwork.
b. Omittingganygonegcomponentgusuallygwillgresultginglessgeffectivegtreatment.
c. Thegmostgimportantgelementgofgpsychotherapeuticgmanagementgisgdruggtherapy.
d. Agtherapeuticgnurse–patientgrelationshipgisgthegmostgimportantgaspectgofgtreatment.

, ANS:g B
Thegthreegcomponentsglistedgasgchoicesga,gc,gandgdgabovegworkgtogethergtogprovidegthegbestgtreat
mentgoutcomes.gWhengonegelementgisgmissing,gtreatmentgisgusuallygcompromised.gNogsinglegel
ementgisgmoregimportantgthangthegothers;ghowever,gpatients‘gneedsggoverngthegapplicationgofgth
egcomponentsgandgpermitgjudiciousguse.

DIF: Cognitiveglevel:gApplying REF:g pp.g1-2
TOP:g Nursinggprocess:gPlanninggMSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

7. Whichgstatementgmostgaccuratelygdescribesgagnurse‘sgrolegregardinggpsychopharmacology?g
Thegpsychiatricgnurse:
a. frequentlygmakesgdecisionsgregardinggadministrationgofgPRNgmedications.
b. mightgadjustgagmedicationgdosegifgagpatientgisgnotgrespondinggpositively.
c. administersgmedicationsgbutgisgnotgresponsiblegforgmonitoringgdruggeffectiveness.
d. shouldgrefergagpatient‘sgquestionsgaboutgdruggsidegandgadversegeffectsgtogthe
psychiatrist.
ANS:g A
NursinggassessmentgandganalysisgofgdatagmightgsuggestgthegneedgforgPRNgmedicationgasgpatientg
anxietygincreasesgorgpsychoticgsymptomsgbecomegmoregacute.gThegnursegisgtheghealthgteamgme
mbergwhogmakesgthisgdetermination.gNursesgaregresponsiblegforgmonitoringgdruggeffectivenessg
asgwellgasgadministeringgmedication.gNursesgshouldgassumegresponsibilitygforgteachinggpatientsg
aboutgthegsidegeffectsgofgmedications.gNursesgcannotgaltergprescribedgdosagesgofgmedicationsgun
lessgtheyghavegprescriptivegprivileges.

DIF: Cognitiveglevel:gUnderstanding REF:g g 2
TOP:g Nursinggprocess:gImplementation MSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

8. Agnursegconsidersgenvironmentalgaspectsgofgmilieugmanagementgwhilegplanninggcaregforgag
newlygadmittedgpatient.gWhichgelementghasgtheghighestgpriority?
a. Norms
b. Safety
c. Balance
d. Structure

ANS:g B
Milieugmanagementgprovidesgagproactivegapproachgtogcare.gSafetygoverridesgallgothergdimensio
nsgofgthegmilieu.

DIF: Cognitiveglevel:gAnalyzing REF:g 2
TOP:g Nursinggprocess:gPlanninggMSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

9. Whengthegtreatmentgteamginganginpatientgpsychiatricgunitginstitutesgagnewgunitgschedulegthatgpro
videsgforgallgpatientsgtogbeginvolvedgingactivitiesgcontinuouslygthroughoutgbothgthegdaygandgearl
ygevening,gwhichgelementgofgmilieugmanagementgneedsgreflectiongandgreconsideration?
a. Norms
b. Balance
c. Limitgsetting
d. Environmentalgmodification
ANS:g B

, Thegsituationgdescribedgsuggestsgagmilieugingwhichgpatientsghavegnogtimegforgplannedgtherapeuti
cgencountersgwithgstaff;ghence,gitgisgagmilieuglackinggbalance.gEnvironmentalgmodificationgisgno
tgagcoregelementgofgmilieugmanagement.gDatagareginsufficientgtogpermitgthegstudentgtogchoosegeit
hergthegcomponentgofgnormsgorglimitgsetting.

DIF: Cognitiveglevel:gAnalyzing REF:g p.g2
TOP:g Nursinggprocess:gEvaluationgMSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

10. Duringganginteractiongwithgagpatient,gagnursegencouragesgthegpatientgtogexpressgfeelings,gidentif
ygstressors,gandgreviewgcopinggstrategies.gThesegnursingginterventionsgrelategmostgtogthegusegof:
a. riskgassessment.
b. behaviorgmodification.
c. therapeuticgcommunication.
d. environmentalgmanipulation.
ANS:g C
Agnursegusesgtherapeuticgcommunicationgtechniquesgasgpartgofgthegtherapeuticgnurse–
patientgrelationship.gBeinggtherapeuticgdoesgnotgimplygthatgthegnursegisgprovidinggtherapy,gagfor
mal,gstructuredgprocess.gRiskgassessmentghasgagdifferentgpurposegrelatedgtogprovisiongofgangappr
opriateglevelgofgcare.gEnvironmentalgmanipulationgisgmoregrelatedgtogmilieugmanagementgthangt
ogtherapeuticgusegofgself.

DIF: Cognitiveglevel:gUnderstanding REF:g g p.g2
TOP:g Nursinggprocess:gImplementation MSC:g NCLEX:gPsychosocialgIntegrity

11. Duringgthegriskgassessmentgphasegofgcaregforgagpsychiatricgpatient,gthegnursegwill:
a. makeganginitialgassessment.
b. confirmgthegpatient‘sgproblem.
c. assessgpotentialgdangerousnessgtogselfgorgothers.
d. determinegtheglevelgofgsupervisiongneededgforgthegpatient.
ANS:g C
Riskgassessmentginvolvesglookinggatgdangerousnessgtogselfgorgothers,gthegdegreegofgdisability,ga
ndgwhethergorgnotgthegindividualgisgacutelygpsychoticgtogdeterminegthegfeasibilitygofgcommunity
-basedgcaregversusghospital-
basedgcare.gRiskgassessmentgusuallygfollowsgtheginitialgassessment.gConfirmationgofgthegpatient
‘sgproblemgisgnotgpartgofgthegriskgassessmentgprotocol.gArranginggentrygintogthegmentalghealthgs
ystemgwillgfollowgriskgassessmentgifgthegpatientgisgassessedgasgneedinggservice.

DIF: Cognitiveglevel:gApplying REF:g g pp.g2-3
TOP:g Nursinggprocess:gAssessment MSC:g NCLEX:gSafe,gEffectivegCaregEnvironment

12. Riskgassessmentgforgagpatientgshowsgthesegfindings:gschizophreniagbutgnotgacutelygpsychoticgatgt
hegmoment;gnotgagdangergtogselfgorgothers;glivesgingparents‘ghome.gWhichgdecisiongregardinggpla
cementgongthegcontinuumgofgcaregisgappropriate?
a. Hospitalizegthegpatient.
b. Dischargegthegpatientgfromgthegsystem.
c. Refergthegpatientgtogoutpatientgservices.
d. Refergthegpatientgtogself-helpgresourcesgingthegcommunity.
ANS:g C