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