TEST BANK - Keltners Psychiatric Nursing, 9th
22 22 22 22 22 22
22 Edition (Steele),
22 22
Chapters 1 - 36 | All Chapters Complete
22 22 22 22 22 22 22 22
,
,Chapter 01: Med, Meds, Milieu
22 22 22 22
Keltner: Psychiatric Nursing, 8th Edition
22 22 22 22
MULTIPLE CHOICE 22
1. A newly licensed asks a nursing recruiter for a description ofnursing practice inthe
22 22 22 22 22 22 22 22 22 22 22 22 22 22
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.‖ 22
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
22 22 22 22 22 22 22 22 22
responsibilities of nursing in such a setting.‖ 22 22 22 22 22 22
c. ―Nursing actions are identified by the institution that distinguishes nursing from 22 22 22 22 22 22 22 2 2 22 22
other mental health professions.‖ 2 2 22 22
d. ―Nursing offers unique contributions to the psychotherapeutic management of 22 22 22 22 22 22 22 22
psychiatric patients.‖ 2 2
ANSWER: D 2 2
Professional role overlap cannot be denied; however, nursing is unique in its focus on and 22 22 22 22 22 22 22 22 22 22 22 22 22 22
applicationofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
22 22 2 22 22 22 22 22 22 22 2
define the professional responsibilities of its members but rather utilizes their unique skills to
22 22 22 22 22 22 22 22 22 22 22 22 22 22
provide holistic care. Ideally, all team members support each other and have functions within the
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
team.
22
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation 22 22 2 2 22 22
MSC: Client Needs: Safe, Effective Care Environment
2 2 2 22 22 22 22 22
2. Which component ofthe nursing process willthe nurse focus upon to address the
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responsibility to match individualpatient needs with appropriate services?
2 22 22 22 22 22 22 22 22
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C 2 2
Proper assessment is critical for being able to determine the appropriate level of services that will
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
provide optimal care while considering patient input and at the lowest cost. Planning and
22 22 22 22 22 22 22 22 22 22 22 22 22 22
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
22 22 22 22 22 22 22 22 22 22 22 22 22
willprovide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
22 22 22 22 22 22 2 22 22 2 22 22
DIF: Cognitive level: Applying TOP: Nursing process: Assessment 22 22 2 2 22 22
MSC: Client Needs: Safe, Effective Care Environment
2 2 2 22 22 22 22 22
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
22 22 22 22 22 22 22 22 2 2
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
22 22 22 22 22 22 22 22 22 22 22 22 22
effective psychotherapeutic management of this client?
22 22 22 22 22 22
a. Discussing the disease process of schizophrenia withthe client and their domestic 22 22 22 22 22 22 2 22 22 22 22
partner
b. Minimizing contact betweenthis patient and other patients to assure a stress free 22 22 22 22 22 22 22 22 22 22 22 22
milieu
c. Administering PRN medicationwhen first observing the evidence that the client 22 22 22 22 22 22 22 22 22 22
, may be hallucinating 22 22
d. Independentlydetermining that behavior modification is appropriate to decrease 2 22 22 22 22 22 22 22
the client‘s paranoid thoughts
22 22 22
ANSWER: A 2 2
An understanding of psychopathology is the foundation on which the three components of
22 22 22 22 22 22 22 22 22 22 22 22
psychotherapeutic management rest; it facilitates therapeutic communicationand provides abasis
22 22 22 22 22 22 22 2 22 22 2
for understanding psychopharmacology and milieu management. Minimizing contact between the
22 22 22 22 22 22 22 22 22 22
patient and others and administering PRN medication indiscriminately are nontherapeutic
22 22 22 22 22 22 22 22 22 22
interventions. Using behavior modification to decrease the frequency of hallucinations would need
22 22 22 22 22 22 22 22 22 22 22 22
to be incorporated into the plan ofcare by the care team.
22 22 22 22 22 22 22 22 22 22 22 22
DIF: Cognitive level: Applying TOP: Nursing process: Implementation 22 22 2 2 22 22
MSC: Client Needs: Safe, Effective Care Environment
2 2 2 22 22 22 22 22
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
22 22 22 22 22 22 22 22 22 22 22 22
intervention is critical in assuring long-term, effective client care as described by
2 22 22 22 22 22 22 22 22 22 22 22
psychotherapeutic management?
22 22
a. Involvement ingroup therapies 22 22 22
b. Focus of close supervision by the unit staff 22 22 22 22 22 22 22
c. Maintaining effective communicationwith support system 22 22 22 22 22
d. Frequentlyscheduled one-on-one time with nursing staff 22 22 22 22 22 22
ANSWER: D 2 2
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
22 22 22 2 22 22 22 22 22 2 22
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this 22 22 22 22 22 22 22 22 22 22 22
connection. While the other options are appropriate and client centered, the nurse-client relation is
2 22 22 22 22 22 22 22 22 22 22 22 22 22
critical in the long-termdeliveryofqualityeffective care to this client.
22 22 22 22 22 22 22 22 22 22 22 22
DIF: Cognitive level: Applying TOP: Nursing process: Implementation 22 22 2 2 22 22
MSC: Client Needs: Psychosocial Integrity
2 2 2 22 22 22
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
22 22 22 22 22 22 22 22 22 22 22 22 22
assessment questiondemonstratesthe nurse‘s understanding ofthe resulting needs ofthe
22 22 22 22 22 22 22 22 22 22 22 22
client?
2
a. ―Will you have any difficultygetting your prescription refilled?‖22 22 22 22 22 22 22 22
b. ―Have you begun experiencing any forms of hallucinations?‖ 22 22 22 22 22 22 22
c. ―What do you expect willoccur since the dosage has been reduced?‖ 22 22 22 22 22 22 22 22 22 22 22
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ 22 22 22 22 22 22 22 22 22 22 22 22
ANSWER: B 2 2
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
22 22 22 22 22 22 22 22 22 22 22 22 22
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
22 22 22 22 22 22 22 22 22 22 22 22 22
assessment questions, theyare not directed at the current needs ofthe client; the identification of
22 22 22 22 22 22 22 22 22 22 22 2 22 22 22 22
emerging psychotic behaviors.
22 22 22
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment 22 22 2 2 22 22
MSC: Client Needs: Physiologic Integrity
2 2 2 22 22 22
22 22 22 22 22 22
22 Edition (Steele),
22 22
Chapters 1 - 36 | All Chapters Complete
22 22 22 22 22 22 22 22
,
,Chapter 01: Med, Meds, Milieu
22 22 22 22
Keltner: Psychiatric Nursing, 8th Edition
22 22 22 22
MULTIPLE CHOICE 22
1. A newly licensed asks a nursing recruiter for a description ofnursing practice inthe
22 22 22 22 22 22 22 22 22 22 22 22 22 22
psychiatric setting. What is the nurse recruiter‘s best response?
2 22 22 2 2 22 22 22 22 22
a. ―The nurse primarily serves in a supportive role to members of the health care
22 22 22 22 22 22 22 22 22 22 22 22 22
delivery team.‖ 22
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
22 22 22 22 22 22 22 22 22
responsibilities of nursing in such a setting.‖ 22 22 22 22 22 22
c. ―Nursing actions are identified by the institution that distinguishes nursing from 22 22 22 22 22 22 22 2 2 22 22
other mental health professions.‖ 2 2 22 22
d. ―Nursing offers unique contributions to the psychotherapeutic management of 22 22 22 22 22 22 22 22
psychiatric patients.‖ 2 2
ANSWER: D 2 2
Professional role overlap cannot be denied; however, nursing is unique in its focus on and 22 22 22 22 22 22 22 22 22 22 22 22 22 22
applicationofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
22 22 2 22 22 22 22 22 22 22 2
define the professional responsibilities of its members but rather utilizes their unique skills to
22 22 22 22 22 22 22 22 22 22 22 22 22 22
provide holistic care. Ideally, all team members support each other and have functions within the
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
team.
22
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation 22 22 2 2 22 22
MSC: Client Needs: Safe, Effective Care Environment
2 2 2 22 22 22 22 22
2. Which component ofthe nursing process willthe nurse focus upon to address the
22 22 22 22 22 22 22 22 22 22 22 22 22
responsibility to match individualpatient needs with appropriate services?
2 22 22 22 22 22 22 22 22
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C 2 2
Proper assessment is critical for being able to determine the appropriate level of services that will
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
provide optimal care while considering patient input and at the lowest cost. Planning and
22 22 22 22 22 22 22 22 22 22 22 22 22 22
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
22 22 22 22 22 22 22 22 22 22 22 22 22
willprovide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
22 22 22 22 22 22 2 22 22 2 22 22
DIF: Cognitive level: Applying TOP: Nursing process: Assessment 22 22 2 2 22 22
MSC: Client Needs: Safe, Effective Care Environment
2 2 2 22 22 22 22 22
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
22 22 22 22 22 22 22 22 2 2
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
22 22 22 22 22 22 22 22 22 22 22 22 22
effective psychotherapeutic management of this client?
22 22 22 22 22 22
a. Discussing the disease process of schizophrenia withthe client and their domestic 22 22 22 22 22 22 2 22 22 22 22
partner
b. Minimizing contact betweenthis patient and other patients to assure a stress free 22 22 22 22 22 22 22 22 22 22 22 22
milieu
c. Administering PRN medicationwhen first observing the evidence that the client 22 22 22 22 22 22 22 22 22 22
, may be hallucinating 22 22
d. Independentlydetermining that behavior modification is appropriate to decrease 2 22 22 22 22 22 22 22
the client‘s paranoid thoughts
22 22 22
ANSWER: A 2 2
An understanding of psychopathology is the foundation on which the three components of
22 22 22 22 22 22 22 22 22 22 22 22
psychotherapeutic management rest; it facilitates therapeutic communicationand provides abasis
22 22 22 22 22 22 22 2 22 22 2
for understanding psychopharmacology and milieu management. Minimizing contact between the
22 22 22 22 22 22 22 22 22 22
patient and others and administering PRN medication indiscriminately are nontherapeutic
22 22 22 22 22 22 22 22 22 22
interventions. Using behavior modification to decrease the frequency of hallucinations would need
22 22 22 22 22 22 22 22 22 22 22 22
to be incorporated into the plan ofcare by the care team.
22 22 22 22 22 22 22 22 22 22 22 22
DIF: Cognitive level: Applying TOP: Nursing process: Implementation 22 22 2 2 22 22
MSC: Client Needs: Safe, Effective Care Environment
2 2 2 22 22 22 22 22
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
22 22 22 22 22 22 22 22 22 22 22 22
intervention is critical in assuring long-term, effective client care as described by
2 22 22 22 22 22 22 22 22 22 22 22
psychotherapeutic management?
22 22
a. Involvement ingroup therapies 22 22 22
b. Focus of close supervision by the unit staff 22 22 22 22 22 22 22
c. Maintaining effective communicationwith support system 22 22 22 22 22
d. Frequentlyscheduled one-on-one time with nursing staff 22 22 22 22 22 22
ANSWER: D 2 2
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
22 22 22 2 22 22 22 22 22 2 22
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this 22 22 22 22 22 22 22 22 22 22 22
connection. While the other options are appropriate and client centered, the nurse-client relation is
2 22 22 22 22 22 22 22 22 22 22 22 22 22
critical in the long-termdeliveryofqualityeffective care to this client.
22 22 22 22 22 22 22 22 22 22 22 22
DIF: Cognitive level: Applying TOP: Nursing process: Implementation 22 22 2 2 22 22
MSC: Client Needs: Psychosocial Integrity
2 2 2 22 22 22
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
22 22 22 22 22 22 22 22 22 22 22 22 22
assessment questiondemonstratesthe nurse‘s understanding ofthe resulting needs ofthe
22 22 22 22 22 22 22 22 22 22 22 22
client?
2
a. ―Will you have any difficultygetting your prescription refilled?‖22 22 22 22 22 22 22 22
b. ―Have you begun experiencing any forms of hallucinations?‖ 22 22 22 22 22 22 22
c. ―What do you expect willoccur since the dosage has been reduced?‖ 22 22 22 22 22 22 22 22 22 22 22
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ 22 22 22 22 22 22 22 22 22 22 22 22
ANSWER: B 2 2
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
22 22 22 22 22 22 22 22 22 22 22 22 22
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
22 22 22 22 22 22 22 22 22 22 22 22 22
assessment questions, theyare not directed at the current needs ofthe client; the identification of
22 22 22 22 22 22 22 22 22 22 22 2 22 22 22 22
emerging psychotic behaviors.
22 22 22
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment 22 22 2 2 22 22
MSC: Client Needs: Physiologic Integrity
2 2 2 22 22 22
