Test BanK
,Table of Contents
Chapter 01 Me, Meds, Milieu 1
Chapter 02 Historical Issues 11
Chapter 03 Legal Issues 19
Chapter 04 Psychobiologic Bases of Behavior 29
Chapter 05 Cultural Issues 38
Chapter 06 Spiritual Issues 47
Chapter 07 Models for Working with Psychiatric Patients 54
Chapter 08 Learning to Communicate Professionally 64
Chapter 09 Working With an Individual Patient 72
Chapter 10 Working With Groups of Patients 86
Chapter 11 Working With the Family 95
Chapter 12 Introduction to Psychotropic Drugs 103
Chapter 13 Antiparkinsonian Drugs 110
Chapter 14 Antipsychotic Drugs 118
Chapter 15 Antidepressant Drugs 128
Chapter 16 Antimanic Drugs 135
Chapter 17 Antianxiety Drugs 143
Chapter 18 Antidementia Drugs 152
Chapter 19 Alternative Preparations and Over-the-Counter Drugs 158
Chapter 20 Introduction to Milieu Management 165
Chapter 21 Variables Affecting the Therapeutic Environment Violence and Suicide 173
Chapter 22 Therapeutic Environment in Various Treatment Settings 185
Chapter 23 Introduction to Psychopathology 191
Chapter 24 Schizophrenia Spectrum and Other Psychotic Disorders 197
Chapter 25 Depressive Disorders 204
Chapter 26 Bipolar Disorders 211
Chapter 27 Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-Related,
Somatic, and Dissociative Disorders 218
Chapter 28 Neurocognitive Disorders 227
Chapter 29 Personality Disorders 236
Chapter 30 Sexual Disorders and Gender Dysphoria 245
Chapter 31 Substance Use Disorders 252
Chapter 32 Eating Disorders 261
Chapter 33 Survivors of Violence and Trauma 268
Chapter 34 Children and Adolescents 277
Chapter 35 Older Adults 284
Chapter 36 Soldiers and Veterans 291
,Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
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.”
ANS: 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
ANS: 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
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
1|Page
, 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
ANS: 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
ANS: 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
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?”
ANS: 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.
2|Page
,Table of Contents
Chapter 01 Me, Meds, Milieu 1
Chapter 02 Historical Issues 11
Chapter 03 Legal Issues 19
Chapter 04 Psychobiologic Bases of Behavior 29
Chapter 05 Cultural Issues 38
Chapter 06 Spiritual Issues 47
Chapter 07 Models for Working with Psychiatric Patients 54
Chapter 08 Learning to Communicate Professionally 64
Chapter 09 Working With an Individual Patient 72
Chapter 10 Working With Groups of Patients 86
Chapter 11 Working With the Family 95
Chapter 12 Introduction to Psychotropic Drugs 103
Chapter 13 Antiparkinsonian Drugs 110
Chapter 14 Antipsychotic Drugs 118
Chapter 15 Antidepressant Drugs 128
Chapter 16 Antimanic Drugs 135
Chapter 17 Antianxiety Drugs 143
Chapter 18 Antidementia Drugs 152
Chapter 19 Alternative Preparations and Over-the-Counter Drugs 158
Chapter 20 Introduction to Milieu Management 165
Chapter 21 Variables Affecting the Therapeutic Environment Violence and Suicide 173
Chapter 22 Therapeutic Environment in Various Treatment Settings 185
Chapter 23 Introduction to Psychopathology 191
Chapter 24 Schizophrenia Spectrum and Other Psychotic Disorders 197
Chapter 25 Depressive Disorders 204
Chapter 26 Bipolar Disorders 211
Chapter 27 Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-Related,
Somatic, and Dissociative Disorders 218
Chapter 28 Neurocognitive Disorders 227
Chapter 29 Personality Disorders 236
Chapter 30 Sexual Disorders and Gender Dysphoria 245
Chapter 31 Substance Use Disorders 252
Chapter 32 Eating Disorders 261
Chapter 33 Survivors of Violence and Trauma 268
Chapter 34 Children and Adolescents 277
Chapter 35 Older Adults 284
Chapter 36 Soldiers and Veterans 291
,Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
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.”
ANS: 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
ANS: 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
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
1|Page
, 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
ANS: 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
ANS: 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
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?”
ANS: 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.
2|Page
