Test bank for psychiatric nursing by norman l keltne debbie steele edition 8th edition.

TEST BANK - Keltners Psychiatric Nursing, 9th
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u Edition (Steele),
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Chapters 1 - 36 | All Chapters Complete
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,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8th Edition
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MULTIPLE CHOICE u




1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
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psychiatric setting. What is the nurse recruiter‘s best response?
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a. ―The nurse primarily serves in a supportive role to members of the health care
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delivery team.‖ u



b. ―The multidisciplinary approach eliminates the need to clearly define the
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responsibilities of nursing in such a setting.‖ u u u u u u



c. ―Nursing actions are identified by the institution that distinguishes nursing from
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other mental health professions.‖ u u u



d. ―Nursing offers unique contributions to the psychotherapeutic management of
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psychiatric patients.‖ u




ANSWER: D u



Professional role overlap cannot be denied; however, nursing is unique in its focus on and
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application of psychotherapeutic management. Neither the facility nor the multidisciplinary
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team define the professional responsibilities of its members but rather utilizes their unique
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skills to provide holistic care. Ideally, all team members support each other and have functions
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within the team.
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DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation u u u u u



MSC: Client Needs: Safe, Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to address the
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responsibility to match individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C u



Proper assessment is critical for being able to determine the appropriate level of services that
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will provide optimal care while considering patient input and at the lowest cost. Planning and
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implementation utilizes the assessment data to identify and execute actions (treatment plan) that
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will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying TOP: Nursing process: Assessment u u u u u



MSC: Client Needs: Safe, Effective Care Environment
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3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
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and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s
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understanding of effective psychotherapeutic management of this client?
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a. Discussing the disease process of schizophrenia with the client and their domestic
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partner
b. Minimizing contact between this patient and other patients to assure a stress free u u u u u u u u u u u u



milieu
c. Administering PRN medication when first observing the evidence that the client u u u u u u u u u u

, may be hallucinating
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d. Independently determining that behavior modification is appropriate to decrease u u u u u u u u



the client‘s paranoid thoughts
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ANSWER: A u



An understanding of psychopathology is the foundation on which the three components of
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psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
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for understanding psychopharmacology and milieu management. Minimizing contact between
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the patient and others and administering PRN medication indiscriminately are nontherapeutic
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interventions. Using behavior modification to decrease the frequency of hallucinations would
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need to be incorporated into the plan of care by the care team.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation u u u u u



MSC: Client Needs: Safe, Effective Care Environment
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4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
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intervention is critical in assuring long-term, effective client care as described by
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psychotherapeutic management?
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a. Involvement in group therapies u u u



b. Focus of close supervision by the unit staff u u u u u u u



c. Maintaining effective communication with support system u u u u u



d. Frequently scheduled one-on-one time with nursing staff u u u u u u




ANSWER: D u



A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on-one time with nursing staff will help in establishing this
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connection. While the other options are appropriate and client centered, the nurse-client
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relation is critical in the long-term delivery of quality effective care to this client.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation u u u u u



MSC: Client Needs: Psychosocial Integrity
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5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
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assessment question demonstrates the nurse‘s understanding of the resulting needs of the
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client?
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a. ―Will you have any difficulty getting your prescription refilled?‖
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b. ―Have you begun experiencing any forms of hallucinations?‖
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c. ―What do you expect will occur since the dosage has been reduced?‖
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d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
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ANSWER: B u



It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
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psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or
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worsening of positive symptoms such as hallucinations and delusions, and negative symptoms
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such as blunted affect, social withdrawal, and poor grooming. While the other options may be
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appropriate assessment questions, they are not directed at the current needs ofthe client; the
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identification of emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment u u u u u



MSC: Client Needs: Physiologic Integrity
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