Keltners Psychiatric Nursing, 9th Edition (Steel
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e), i
Chapters 1 - 36 | All Chapters Complete
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,Chapteri01:iMed,iMeds,iMilieu
Keltner:iPsychiatriciNursing,i8thiEdition
MULTIPLEiCHOICE
1. Ainewlyilicensediasksiainursingirecruiteriforiaidescriptioniofinursingipracticeiinitheips
ychiatricisetting.iWhati isitheinurseirecruiter‘sibestiresponse?
a. ―Theinur seiprimarilyiservesiiniaisupportiveiroleitoimembersiofitheihealthicare
deliveryiteam.‖
b. ―Theimultidisciplinaryiapproachieliminatesitheineeditoiclearlyidefineithe
responsibilitiesiofinursingiinisuchiaisetting.‖
c. ―Nursingiactionsiareiidentifiedibyitheiinstitutionithatidistinguishesinursingifrom
otherimentalihealthiprofessions.‖
d. ―Nursingioffersiuniqueicontributionsitoitheipsychotherapeuticimanagementiof
psychiatrici patients.‖
ANSWER:i D
Professionaliroleioverlapicannotibeidenied;ihowever,inursingiisiuniqueiiniitsifocusioniandiapplic
ationiofipsychotherapeuticimanagement.iNeitheritheifacilityinoritheimultidisciplinaryiteamidefin
eitheiprofessionaliresponsibilitiesiofiitsimembersibutiratheriutilizesitheiriuniqueiskillsitoiprovidei
holisticicare.iIdeally,ialliteamimembersisupportieachiotheriandihaveifunctionsiwithinitheiteam.
DIF: Cognitiveilevel:iAnalyzing
TOP:i Nursingiprocess:iImplementationiMSC:i ClientiNeeds:iSafe,iEffectiveiC
areiEnvironment
2. Whichicomponentiofitheinursingiprocessiwillitheinurseifocusiuponitoiaddressitheires
ponsibilityitoimatchiindividualipatientineedsiwithiappropriateiservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER:i C
Properiassessmentiisicriticaliforibeingiableitoidetermineitheiappropriateileveliofiservicesithatiwill
iprovideioptimalicareiwhileiconsideringipatientiinputiandiatitheilowesticost.iPlanningiandiimplem
entationiutilizesitheiassessmentidataitoiidentifyiandiexecuteiactionsi(treatmentiplan)ithatiwillipro
videiappropriateicare.iEvaluationivalidatesitheieffectivenessiofitheitreatmentiplan.
DIF: Cognitiveilevel:iApplying
TOP:i Nursingiprocess:iAssessmentiMSC:i ClientiNeeds:iSafe,iEffectiveiC
areiEnvironment
3. Aniadultidiagnosediwithiparanoidischizophreniaifrequentiexperiencesiauditoryihallucinationsia
ndiwalksiaboutitheiunit,imuttering.iWhichinursingiactionidemonstratesitheinurse‘siunderstandi
ngiofieffectiveipsychotherapeuticimanagementiofithisiclient?
a. Discussingitheidiseaseiprocessiofischizophreniaiwithitheiclientianditheiridomestic
partner
b. Minimizingicontactibetweenithisipatientiandiotheripatientsitoiassureiaistressifree
milieu
c. AdministeringiPRNimedicationiwhenifirstiobservingitheievidenceithatitheiclient
, mayibeihallucinating
d. Independentlyideterminingithatibehaviorimodificationiisiappropriateitoidecrease
theiclient‘siparanoidithoughts
ANSWER:i A
Aniunderstandingiofipsychopathologyiisitheifoundationioniwhichitheithreeicomponentsiofipsychot
herapeuticimanagementirest;iitifacilitatesitherapeuticicommunicationiandiprovidesiaibasisiforiunde
rstandingipsychopharmacologyiandimilieuimanagement.iMinimizingicontactibetweenitheipatienti
andiothersiandiadministeringiPRNimedicationiindiscriminatelyiareinontherapeuticiinterventions.i
Usingibehaviorimodificationitoidecreaseitheifrequencyiofihallucinationsiwouldineeditoibeiincorpo
ratediintoitheiplanioficareibyitheicareiteam.
DIF: Cognitiveilevel:iApplying
TOP:i Nursingiprocess:iImplementationiMSC:i ClientiNeeds:iSafe,iEffectiveiC
areiEnvironment
4. Aniadultidiagnosediwithichronicidepressioniisihospitalizediafteriaisuicideiattempt.iWhichiint
erventioniisicriticaliiniassuringilong-
term,ieffectiveiclienticareiasidescribedibyipsychotherapeuticimanagement?
a. Involvementiinigroupitherapies
b. Focusioficloseisupervisionibyitheiunitistaff
c. Maintainingieffectiveicommunicationiwithisupportisystem
d. Frequentlyischeduledione-on-oneitimeiwithinursingistaff
ANSWER:i D
Aicriticalielementiofipsychotherapeuticimanagementiisitheipresenceiofiaitherapeutic
nurse-patientirelationship.iOne-on-
oneitimeiwithinursingistaffiwillihelpiiniestablishingithisiconnection.iWhileitheiotherioptionsiareia
ppropriateiandiclienticentered,itheinurse-clientirelationiisicriticaliinitheilong-
termideliveryiofiqualityieffectiveicareitoithisiclient.
DIF: Cognitiveilevel:iApplying
TOP:i Nursingiprocess:iImplementationiMSC:i ClientiNeeds:iPsychosocialiInte
grity
5. Aipatient‘sihaloperidolidosageiwasireducedi2iweeksiagoitoidecreaseisideieffects.iWhatiass
essmentiquestionidemonstratesitheinurse‘siunderstandingiofitheiresultingineedsiofitheiclient
?
a. ―Williyouihaveianyidifficultyigettingi youriprescriptionirefilled?‖
b. ―Havei youibeguniexperiencingianyiformsiofihallucinations?‖
c. ―Whatidoiyouiexpectiwillioccurisinceitheidosageihasibeenireduced?‖
d. ―WhaticaniIidoitoihelpi youimanageithisireductioniinihaloperidolitherapy?‖
ANSWER:i B
Itiwillibeinecessaryiforitheinurseitoiassessiforiexacerbationiofitheipatient‘sisymptomsiofipsychos
isiasiwelliasiforiailesseningiofisideieffects.iDosageidecreaseimightileaditoitheireturnioriworsening
iofipositiveisymptomsisuchiasihallucinations iandidelusions,iandinegativeisymptomsisuchiasiblun
tediaffect,isocialiwithdrawal,iandipoorigrooming.iWhileitheiotherioptionsimayibeiappropriateias
sessmentiquestions,itheyiareinotidirectediatitheicurrentineedsiofitheiclient;itheiidentificationiofie
mergingipsychoticibehaviors.
DIF: Cognitiveilevel:iAnalyzing
TOP:i Nursingiprocess:iAssessmentiMSC:i ClientiNeeds:iPhysiologiciInteg
rity