TEST BANK - Keltners Psychiatric Nursing, 9th
s s s s s s
s Edition (Steele),
s s
Chapters 1 - 36 | All Chapters Complete
s s s s s s s s
,
,Chapter 01: Med, Meds, Milieu
s s s s
Keltner: Psychiatric Nursing, 8th Edition
s s s s
MULTIPLE CHOICE s
1. A newly licensed asks a nursing recruiter for a description of nursing practice in
s s s s s s s s s s s s s
thepsychiatric setting. What is the nurse recruiter‘s best response?
s s s s s s s s s s
a. ―The nurse primarily serves in a supportive role to members of the health care
s s s s s s s s s s s s s
delivery team.‖ s
b. ―The multidisciplinary approach eliminates the need to clearly define the
s s s s s s s s s
responsibilities of nursing in such a setting.‖ s s s s s s
c. ―Nursing actions are identified by the institution that distinguishes nursing from
s s s s s s s s s s
other mental health professions.‖s s s
d. ―Nursing offers unique contributions to the psychotherapeutic management of
s s s s s s s s
psychiatric patients.‖ s
ANSWER: D s
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
s s s s s s s s s s s s s s
application of psychotherapeutic management. Neither the facility nor the
s s s s s s s s s
multidisciplinaryteam define the professional responsibilities of its members but rather
s s s s s s s s s s s
utilizes their unique skills to provide holistic care. Ideally, all team members support each
s s s s s s s s s s s s s s
other and have functions within the team.
s s s s s s s
DIF: Cognitive level: Analyzing TOP: Nursing process: s s s s
ImplementationMSC: Client Needs: Safe, Effective Care Environment
s s s s s s s s
2. Which component of the nursing process will the nurse focus upon to address
s s s s s s s s s s s s
theresponsibility to match individual patient needs with appropriate services?
s s s s s s s s s s
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C s
Proper assessment is critical for being able to determine the appropriate level of services that
s s s s s s s s s s s s s s
will provide optimal care while considering patient input and at the lowest cost. Planning and
s s s s s s s s s s s s s s s
implementation utilizes the assessment data to identify and execute actions (treatment plan)
s s s s s s s s s s s s
that will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
s s s s s s s s s s s s s
DIF: Cognitive level: Applying TOP: Nursing process: s s s s
AssessmentMSC: Client Needs: Safe, Effective Care Environment
s s s s s s s s
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory
s s s s s s s s
hallucinationsand walks about the unit, muttering. Which nursing action demonstrates the
s s s s s s s s s s s s
nurse‘s understanding of effective psychotherapeutic management of this client?
s s s s s s s s s
a. Discussing the disease process of schizophrenia with the client and their domestic
s s s s s s s s s s s
partner
b. Minimizing contact between this patient and other patients to assure a stress free
s s s s s s s s s s s s
milieu
c. Administering PRN medication when first observing the evidence that the client s s s s s s s s s s
, may be hallucinating s s
d. Independently determining that behavior modification is appropriate to decrease s s s s s s s s
the client‘s paranoid thoughts
s s s
ANSWER: A s
An understanding of psychopathology is the foundation on which the three components of
s s s s s s s s s s s s
psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
s s s s s s s s s s s
for understanding psychopharmacology and milieu management. Minimizing contact between
s s s s s s s s s
the patient and others and administering PRN medication indiscriminately are nontherapeutic
s s s s s s s s s s s
interventions. Using behavior modification to decrease the frequency of hallucinations would
s s s s s s s s s s s
need to be incorporated into the plan of care by the care team.
s s s s s s s s s s s s s
DIF: Cognitive level: Applying TOP: Nursing process: s s s s
ImplementationMSC: Client Needs: Safe, Effective Care Environment
s s s s s s s s
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt.
s s s s s s s s s s s
Whichintervention is critical in assuring long-term, effective client care as described by
s s s s s s s s s s s s s
psychotherapeutic management?
s s
a. Involvement in group therapies s s s
b. Focus of close supervision by the unit staff s s s s s s s
c. Maintaining effective communication with support system s s s s s
d. Frequently scheduled one-on-one time with nursing staff s s s s s s
ANSWER: D s
A critical element of psychotherapeutic management is the presence of a therapeutic
s s s s s s s s s s s
nurse-patient relationship. One-on-one time with nursing staff will help in establishing
s s s s s s s s s s
thisconnection. While the other options are appropriate and client centered, the nurse-client
s s s s s s s s s s s s s
relation is critical in the long-term delivery of quality effective care to this client.
s s s s s s s s s s s s s s
DIF: Cognitive level: Applying TOP: Nursing process: s s s s
ImplementationMSC: Client Needs: Psychosocial Integrity
s s s s s s
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
s s s s s s s s s s s s s
assessment question demonstrates the nurse‘s understanding of the resulting needs of
s s s s s s s s s s s
theclient?
s s
a. ―Will you have any difficulty getting your prescription refilled?‖
s s s s s s s s
b. ―Have you begun experiencing any forms of hallucinations?‖
s s s s s s s
c. ―What do you expect will occur since the dosage has been reduced?‖
s s s s s s s s s s s
d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
s s s s s s s s s s s s
ANSWER: B s
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
s s s s s s s s s s s s s s s
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or
s s s s s s s s s s s s s s s s s s
worsening of positive symptoms such as hallucinations and delusions, and negative symptoms
s s s s s s s s s s s s
such as blunted affect, social withdrawal, and poor grooming. While the other options may be
s s s s s s s s s s s s s s s
appropriate assessment questions, they are not directed at the current needs ofthe client; the
s s s s s s s s s s s s s s s
identification of emerging psychotic behaviors.
s s s s s
DIF: Cognitive level: Analyzing TOP: Nursing process: s s s s
AssessmentMSC: Client Needs: Physiologic Integrity
s s s s s s
s s s s s s
s Edition (Steele),
s s
Chapters 1 - 36 | All Chapters Complete
s s s s s s s s
,
,Chapter 01: Med, Meds, Milieu
s s s s
Keltner: Psychiatric Nursing, 8th Edition
s s s s
MULTIPLE CHOICE s
1. A newly licensed asks a nursing recruiter for a description of nursing practice in
s s s s s s s s s s s s s
thepsychiatric setting. What is the nurse recruiter‘s best response?
s s s s s s s s s s
a. ―The nurse primarily serves in a supportive role to members of the health care
s s s s s s s s s s s s s
delivery team.‖ s
b. ―The multidisciplinary approach eliminates the need to clearly define the
s s s s s s s s s
responsibilities of nursing in such a setting.‖ s s s s s s
c. ―Nursing actions are identified by the institution that distinguishes nursing from
s s s s s s s s s s
other mental health professions.‖s s s
d. ―Nursing offers unique contributions to the psychotherapeutic management of
s s s s s s s s
psychiatric patients.‖ s
ANSWER: D s
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
s s s s s s s s s s s s s s
application of psychotherapeutic management. Neither the facility nor the
s s s s s s s s s
multidisciplinaryteam define the professional responsibilities of its members but rather
s s s s s s s s s s s
utilizes their unique skills to provide holistic care. Ideally, all team members support each
s s s s s s s s s s s s s s
other and have functions within the team.
s s s s s s s
DIF: Cognitive level: Analyzing TOP: Nursing process: s s s s
ImplementationMSC: Client Needs: Safe, Effective Care Environment
s s s s s s s s
2. Which component of the nursing process will the nurse focus upon to address
s s s s s s s s s s s s
theresponsibility to match individual patient needs with appropriate services?
s s s s s s s s s s
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C s
Proper assessment is critical for being able to determine the appropriate level of services that
s s s s s s s s s s s s s s
will provide optimal care while considering patient input and at the lowest cost. Planning and
s s s s s s s s s s s s s s s
implementation utilizes the assessment data to identify and execute actions (treatment plan)
s s s s s s s s s s s s
that will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
s s s s s s s s s s s s s
DIF: Cognitive level: Applying TOP: Nursing process: s s s s
AssessmentMSC: Client Needs: Safe, Effective Care Environment
s s s s s s s s
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory
s s s s s s s s
hallucinationsand walks about the unit, muttering. Which nursing action demonstrates the
s s s s s s s s s s s s
nurse‘s understanding of effective psychotherapeutic management of this client?
s s s s s s s s s
a. Discussing the disease process of schizophrenia with the client and their domestic
s s s s s s s s s s s
partner
b. Minimizing contact between this patient and other patients to assure a stress free
s s s s s s s s s s s s
milieu
c. Administering PRN medication when first observing the evidence that the client s s s s s s s s s s
, may be hallucinating s s
d. Independently determining that behavior modification is appropriate to decrease s s s s s s s s
the client‘s paranoid thoughts
s s s
ANSWER: A s
An understanding of psychopathology is the foundation on which the three components of
s s s s s s s s s s s s
psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
s s s s s s s s s s s
for understanding psychopharmacology and milieu management. Minimizing contact between
s s s s s s s s s
the patient and others and administering PRN medication indiscriminately are nontherapeutic
s s s s s s s s s s s
interventions. Using behavior modification to decrease the frequency of hallucinations would
s s s s s s s s s s s
need to be incorporated into the plan of care by the care team.
s s s s s s s s s s s s s
DIF: Cognitive level: Applying TOP: Nursing process: s s s s
ImplementationMSC: Client Needs: Safe, Effective Care Environment
s s s s s s s s
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt.
s s s s s s s s s s s
Whichintervention is critical in assuring long-term, effective client care as described by
s s s s s s s s s s s s s
psychotherapeutic management?
s s
a. Involvement in group therapies s s s
b. Focus of close supervision by the unit staff s s s s s s s
c. Maintaining effective communication with support system s s s s s
d. Frequently scheduled one-on-one time with nursing staff s s s s s s
ANSWER: D s
A critical element of psychotherapeutic management is the presence of a therapeutic
s s s s s s s s s s s
nurse-patient relationship. One-on-one time with nursing staff will help in establishing
s s s s s s s s s s
thisconnection. While the other options are appropriate and client centered, the nurse-client
s s s s s s s s s s s s s
relation is critical in the long-term delivery of quality effective care to this client.
s s s s s s s s s s s s s s
DIF: Cognitive level: Applying TOP: Nursing process: s s s s
ImplementationMSC: Client Needs: Psychosocial Integrity
s s s s s s
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
s s s s s s s s s s s s s
assessment question demonstrates the nurse‘s understanding of the resulting needs of
s s s s s s s s s s s
theclient?
s s
a. ―Will you have any difficulty getting your prescription refilled?‖
s s s s s s s s
b. ―Have you begun experiencing any forms of hallucinations?‖
s s s s s s s
c. ―What do you expect will occur since the dosage has been reduced?‖
s s s s s s s s s s s
d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
s s s s s s s s s s s s
ANSWER: B s
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
s s s s s s s s s s s s s s s
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or
s s s s s s s s s s s s s s s s s s
worsening of positive symptoms such as hallucinations and delusions, and negative symptoms
s s s s s s s s s s s s
such as blunted affect, social withdrawal, and poor grooming. While the other options may be
s s s s s s s s s s s s s s s
appropriate assessment questions, they are not directed at the current needs ofthe client; the
s s s s s s s s s s s s s s s
identification of emerging psychotic behaviors.
s s s s s
DIF: Cognitive level: Analyzing TOP: Nursing process: s s s s
AssessmentMSC: Client Needs: Physiologic Integrity
s s s s s s
