(Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8th Edition
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MULTIPLE CHOICE fo
1. A newly licensed asks a nursing recruiter for a description of nursing practice in thep
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sychiatric 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.‖ fo
b. ―The multidisciplinary approach eliminates the need to clearly define the
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responsibilities of nursing in such a setting.‖ fo fo fo fo fo fo
c. ―Nursing actions are identified by the institution that distinguishes nursing from
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other mental health professions.‖ fo fo fo
d. ―Nursing offers unique contributions to the psychotherapeutic management of
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psychiatric patients.‖ fo
ANSWER: D fo
Professional role overlap cannot be denied; however, nursing is unique in its focus on and appl
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ication of psychotherapeutic management. Neither the facility nor the multidisciplinaryteam de
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fine the professional responsibilities of its members but rather utilizes their unique skills to pro
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vide holistic care. Ideally, all team members support each other and have functions within the t
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eam.
DIF: Cognitive level: Analyzing fo fo
TOP: Nursing process: ImplementationMSC: Client Needs: Safe, Effective
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Care Environment fo
2. Which component of the nursing process will the nurse focus upon to address ther
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esponsibility to match individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C fo
Proper assessment is critical for being able to determine the appropriate level of services that wi
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ll provide optimal care while considering patient input and at the lowest cost. Planning and imp
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lementation utilizes the assessment data to identify and execute actions (treatment plan) that wi
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ll provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying fo fo
TOP: Nursing process: AssessmentMSC: Client Needs: Safe, Effective
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Care Environment fo
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinationsa
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nd walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understand
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ing 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
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milieu
c. Administering PRN medication when first observing the evidence that the client fo fo fo fo fo fo fo fo fo fo
, may be hallucinating fo fo
d. Independently determining that behavior modification is appropriate to decrease fo fo fo fo fo fo fo fo
the client‘s paranoid thoughts
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ANSWER: A fo
An understanding of psychopathology is the foundation on which the three components of psych
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otherapeutic management rest; it facilitates therapeutic communication and provides abasis for un
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derstanding psychopharmacology and milieu management. Minimizing contact between the pati
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ent and others and administering PRN medication indiscriminately are nontherapeutic interventi
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ons. Using behavior modification to decrease the frequency of hallucinations would need to be in
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corporated into the plan of care by the care team. fo fo fo fo fo fo fo fo fo
DIF: Cognitive level: Applying fo fo
TOP: Nursing process: ImplementationMSC: Client Needs: Safe, Effective
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Care Environment fo
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Whichin
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tervention is critical in assuring long- fo fo fo fo fo
term, effective client care as described by psychotherapeutic management?
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a. Involvement in group therapies fo fo fo
b. Focus of close supervision by the unit staff fo fo fo fo fo fo fo
c. Maintaining effective communication with support system fo fo fo fo fo
d. Frequently scheduled one-on-one time with nursing staff fo fo fo fo fo fo
ANSWER: D fo
A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on- fo fo
one time with nursing staff will help in establishing thisconnection. While the other options are
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appropriate and client centered, the nurse-client relation is critical in the long-
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term delivery of quality effective care to this client.
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DIF: Cognitive level: Applying fo fo
TOP: Nursing process: ImplementationMSC: Client Needs: Psychosocial In
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tegrity
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What as
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sessment question demonstrates the nurse‘s understanding of the resulting needs of theclie
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nt?
a. ―Will you have any difficulty getting your prescription refilled?‖
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b. ―Have you begun experiencing any forms of hallucinations?‖ fo fo fo fo fo fo fo
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 fo
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psych
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osis as well as for a lessening of side effects. Dosage decrease might lead to the return or worse
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ning of positive symptoms such as hallucinations and delusions, and negative symptoms such
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as blunted affect, social withdrawal, and poor grooming. While the other options may be appro
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priate assessment questions, they are not directed at the current needs ofthe client; the identifica
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tion of emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing fo fo
TOP: Nursing process: AssessmentMSC: Client Needs: Physiologic Int
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egrity