,Chapter 01: Me, Meds, Milieu
f f f f
Steele: Keltner’s Psychiatric Nursing, 9th Edition
f f f f f
MULTIPLE CHOICE f
1. A newly licensed nurse asks a nursing recruiter for a description of nursing
f f f f f f f f f f f f
fpractice in the psychiatric setting. What is the nurse recruiter‘s best
f f f f f f f f f f
f response?
a. ―The nurse primarily serves in a supportive role to members of the health
f f f f N f f f f f f f f
care f
delivery team.‖ f
b. ―The multidisciplinary approach eliminates the need to clearly define
f f f f f f f f
the responsibilities of nursing in such a setting.‖
f f f f f f f f
c. ―Nursing actions are identified by the institution that distinguishes f f f f f f f f
nursing from f f
other mental health professions.‖ f f f
d. ―Nursing offers unique contributions to the psychotherapeutic f f f f f f
management of f f
psychiatric patients.‖ f
ANS: D
Professional role overlap cannot be denied; however, nursing is unique in
f f f f f f f f f f
fits focus on and application of psychotherapeutic management. Neither the
f f f f f f f f f
ffacility nor the multidisciplinary team define the professional responsibilities of
f f f f f f f f f
fits members but rather utilizes their unique skills to provide holistic care.
f f f f f f f f f f f
f Ideally, all team members support each other and have functions within
f f f f f f f f f f
fthe team. f
DIF: Cognitive level: Analyzing TOP: Nursing process: f f f
Implementation MSC: Client Needs: Safe, Effective Care
f f f f f f
fEnvironment
2. Which component of the nursing process will the nurse focus
f f f f f f f f f
upon to address the responsibility to match individual patient
f f f f f f f f f
needs with appropriate services?
f f f f
a. Planning
b. Evaluation
c. Assessment
, d. Implementation
ANS: C
Proper assessment is critical for being able to determine the appropriate
f f f f f f f f f f
flevel of services that will provide optimal care while considering patient
f f f f f f f f f f
finput and at the lowest cost. Planning and implementation utilizes the
f f f f f f f f f f
fassessment data to identify and execute actions (treatment plan) that will
f f f f f f f f f f
provide appropriate care. Evaluation validates the effectiveness of the treatment
f f f f f f f f f f
fplan.
DIF: Cognitive level: Applyingf f TOP: Nursing process: f
, Assessment MSC: f Client Needs: Safe, Effective Care Environment f f f f f
3. An adult diagnosed with paranoid schizophrenia frequently experiences
f f f f f f f
f auditory hallucinations and walks about the unit, muttering. Which nursing
f f f f f f f f f
f action demonstrates the nurse‘s understanding of effective psychotherapeutic
f f f f f f f
fmanagement of this client? f f f
a. Discussing the disease process of schizophrenia with the client and f f f f f f f f f
their domestic f f
partner
b. Minimizing contact between this patient and other patients to f f f f f f f f
assure a stress-free
f f f
milieu
c. Administering PRN medication when first observing the evidence that f f f f f f f f
the client f f
may be hallucinating f f
d. Independently determining that behavior modification is appropriate to f f f f f f f
decrease f
the client‘s paranoid thoughts f f f
ANS: A
An understanding of psychopathology is the foundation on which the three
f f f f f f f f f f
components of psychotherapeutic management rest; it facilitates therapeutic
f f f f f f f f
communication and provides a basis for understanding psychopharmacology and
f f f f f f f f f
milieu management. Minimizing contact between the patient and others and
f f f f f f f f f f
administering PRN medication indiscriminately are nontherapeutic interventions.
f f f f f f f
Using behavior modification to decrease the frequency of hallucinations would
f f f f f f f f f f
need to be incorporated into the plan of care by the care team.
f f f f f f f f f f f f f
DIF: Cognitive level: Applying TOP: Nursing process: f f f
fImplementation MSC: Client Needs: Safe, Effective Care f f f f f
f Environment
4. An adult diagnosed with chronic depression is hospitalized after a
f f f f f f f f f
fsuicide attempt. Which intervention is critical in assuring long-term,
f f f f f f f f
feffective client care as described by psychotherapeutic management?f f f f f f f
a. Involvement in group therapies f f f
b. Focus of close supervision by the unit staff f f f f f f f f
c. Maintaining effective communication with support f f f f
system f
d. Frequently scheduled one-on-one time with nursing f f f f f
staff f
ANS: D
A critical element of psychotherapeutic management is the presence of a
f f f f f f f f f f
ftherapeutic nurse-patient relationship. One-on-one time with nursing staff will help
f f f f f f f f f
in establishing this connection. While the other options are appropriate and
f f f f f f f f f f f
client centered, the nurse-client relation is critical in the long-term delivery
f f f f f f f f f f f
of quality effective care f f f f
to this client. f f
DIF: Cognitive level: Applying TOP: Nursing process: f f f
fImplementation MSC: Client Needs: Psychosocial Integrity f f f f
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
f f f f f f f f f f f
f f f f
Steele: Keltner’s Psychiatric Nursing, 9th Edition
f f f f f
MULTIPLE CHOICE f
1. A newly licensed nurse asks a nursing recruiter for a description of nursing
f f f f f f f f f f f f
fpractice in the psychiatric setting. What is the nurse recruiter‘s best
f f f f f f f f f f
f response?
a. ―The nurse primarily serves in a supportive role to members of the health
f f f f N f f f f f f f f
care f
delivery team.‖ f
b. ―The multidisciplinary approach eliminates the need to clearly define
f f f f f f f f
the responsibilities of nursing in such a setting.‖
f f f f f f f f
c. ―Nursing actions are identified by the institution that distinguishes f f f f f f f f
nursing from f f
other mental health professions.‖ f f f
d. ―Nursing offers unique contributions to the psychotherapeutic f f f f f f
management of f f
psychiatric patients.‖ f
ANS: D
Professional role overlap cannot be denied; however, nursing is unique in
f f f f f f f f f f
fits focus on and application of psychotherapeutic management. Neither the
f f f f f f f f f
ffacility nor the multidisciplinary team define the professional responsibilities of
f f f f f f f f f
fits members but rather utilizes their unique skills to provide holistic care.
f f f f f f f f f f f
f Ideally, all team members support each other and have functions within
f f f f f f f f f f
fthe team. f
DIF: Cognitive level: Analyzing TOP: Nursing process: f f f
Implementation MSC: Client Needs: Safe, Effective Care
f f f f f f
fEnvironment
2. Which component of the nursing process will the nurse focus
f f f f f f f f f
upon to address the responsibility to match individual patient
f f f f f f f f f
needs with appropriate services?
f f f f
a. Planning
b. Evaluation
c. Assessment
, d. Implementation
ANS: C
Proper assessment is critical for being able to determine the appropriate
f f f f f f f f f f
flevel of services that will provide optimal care while considering patient
f f f f f f f f f f
finput and at the lowest cost. Planning and implementation utilizes the
f f f f f f f f f f
fassessment data to identify and execute actions (treatment plan) that will
f f f f f f f f f f
provide appropriate care. Evaluation validates the effectiveness of the treatment
f f f f f f f f f f
fplan.
DIF: Cognitive level: Applyingf f TOP: Nursing process: f
, Assessment MSC: f Client Needs: Safe, Effective Care Environment f f f f f
3. An adult diagnosed with paranoid schizophrenia frequently experiences
f f f f f f f
f auditory hallucinations and walks about the unit, muttering. Which nursing
f f f f f f f f f
f action demonstrates the nurse‘s understanding of effective psychotherapeutic
f f f f f f f
fmanagement of this client? f f f
a. Discussing the disease process of schizophrenia with the client and f f f f f f f f f
their domestic f f
partner
b. Minimizing contact between this patient and other patients to f f f f f f f f
assure a stress-free
f f f
milieu
c. Administering PRN medication when first observing the evidence that f f f f f f f f
the client f f
may be hallucinating f f
d. Independently determining that behavior modification is appropriate to f f f f f f f
decrease f
the client‘s paranoid thoughts f f f
ANS: A
An understanding of psychopathology is the foundation on which the three
f f f f f f f f f f
components of psychotherapeutic management rest; it facilitates therapeutic
f f f f f f f f
communication and provides a basis for understanding psychopharmacology and
f f f f f f f f f
milieu management. Minimizing contact between the patient and others and
f f f f f f f f f f
administering PRN medication indiscriminately are nontherapeutic interventions.
f f f f f f f
Using behavior modification to decrease the frequency of hallucinations would
f f f f f f f f f f
need to be incorporated into the plan of care by the care team.
f f f f f f f f f f f f f
DIF: Cognitive level: Applying TOP: Nursing process: f f f
fImplementation MSC: Client Needs: Safe, Effective Care f f f f f
f Environment
4. An adult diagnosed with chronic depression is hospitalized after a
f f f f f f f f f
fsuicide attempt. Which intervention is critical in assuring long-term,
f f f f f f f f
feffective client care as described by psychotherapeutic management?f f f f f f f
a. Involvement in group therapies f f f
b. Focus of close supervision by the unit staff f f f f f f f f
c. Maintaining effective communication with support f f f f
system f
d. Frequently scheduled one-on-one time with nursing f f f f f
staff f
ANS: D
A critical element of psychotherapeutic management is the presence of a
f f f f f f f f f f
ftherapeutic nurse-patient relationship. One-on-one time with nursing staff will help
f f f f f f f f f
in establishing this connection. While the other options are appropriate and
f f f f f f f f f f f
client centered, the nurse-client relation is critical in the long-term delivery
f f f f f f f f f f f
of quality effective care f f f f
to this client. f f
DIF: Cognitive level: Applying TOP: Nursing process: f f f
fImplementation MSC: Client Needs: Psychosocial Integrity f f f f
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
f f f f f f f f f f f
