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