Stuvia.com - The Marketplace to Buy and Sell your Study Material
ss ss ss ss ss ss ss ss ss ss
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
Stuvia.com - The Marketplace to Buy and Sell your Study Material
Chapter01:Med,Meds,Milieu
s s s s
Keltner:PsychiatricNursing,8thEdition
s s s
MULTIPLECHOICE
1. Anewlylicensedasksanursinglrecruiterforadescriptionofnursinglpracticelinthelpsyc s
s s hiatricsetting. Whatisthelnurselrecruiter‟s bestresponse?
s ss ss
a. “Thelnurselprimarilyservesinlasupportiveroletomembersofthehealthcaredeli s s
s s veryteam.”
b. “Themultidisciplinaryapproacheliminateslthelneedtolclearlydefineltheres
s s ponsibilitiesofnursinginsuchasetting.”
c. “Nursinglactionslarelidentifiedbytheinstitutionthatdistinguishesnursinglfromoth s
ss ermentallhealthprofessions.”
s s
d. “Nursingloffersluniquecontributionstothepsychotherapeuticmanagementofps s
ss ychiatricpatients.”
ANS: D ss
Professionalroleoverlap cannotlbedenied; however, nursingisluniquelinits focusonandlapplic
ss ss ss ss
ationlofpsychotherapeuticlmanagement.Neitherthelfacilitynorthelmultidisciplinaryteamdefi
ss s
netheprofessionalresponsibilitiesofitsmembersbutratherutilizestheiruniqueskillstolprovi
ss s s
s deholisticlcare. Ideally, all teamlmemberssupporteachlotherandhavefunctionswithinltheltea
s ss ss ss
m.
s s
DIF: Cognitivellevel: Analyzing ss
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:Safe,EffectivelCar
ss s ss s s s
ss elEnvironment
2. Which l component of the l nur sinUg pS
ro ceNs s w
Till theOnursefocusuponltoladdressltheres N R I G B.C M s s s
sponsibilitytolmatchindividualpatientneedswithappropriateservices? s
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: C ss
Properassessmentislcritical forbeinglabletodeterminetheappropriatelevelofservices thatlwill p ss ss ss
rovideoptimalcarelwhilelconsideringpatientinputand at thelowestlcost. Planningandimplement
ss ss ss s
ationlutilizeslthelassessment datalto identifyandexecuteactions(treatmentplan) thatwillprovide
ss ss s s
appropriatecare. Evaluation validatestheleffectiveness ofthetreatmentplan.
ss ss ss ss
DIF: Cognitivellevel: Applying ss
TOP: Nursingprocess:AssessmentlMSC: ClientNeeds:Safe,EffectiveCa
ss s ss s s s s
ss reEnvironment
s
3. An adultdiagnosedwithparanoidschizophreniafrequentlexperienceslauditoryhallucinationsan
ss
dwalksabouttheunit, muttering. Whichnursingactionldemonstratesthenurse‟s understandingl
ss ss ss ss
ofeffectivepsychotherapeuticmanagementofthisclient?
s s
a. Discussingthediseaseprocesslofschizophreniawiththeclientandltheirdomesticlpar s s
tner s s
b. Minimizingcontactbetweenthispatientandotherpatientstoassurelastressfreemili s
eu s s
c. Administering PRNmedicationwhenlfirstobservingtheevidencelthattheclient
s s
NURSINGTB.COM
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
Stuvia.com - The Marketplace to Buy and Sell your Study Material
maybehallucinating
d. Independentlydeterminingthatlbehaviormodificationlisappropriatetoldecreaseth
s s eclient‟slparanoidthoughts s
ANS: A ss
Anunderstandinglofpsychopathologyislthelfoundationonlwhichthethreecomponentsofpsyc
s
hotherapeuticlmanagementrest; it facilitates therapeuticcommunicationandprovidesabasis fo
ss ss s s ss
runderstandinglpsychopharmacologyandlmilieulmanagement.Minimizingcontactbetweenth
ss s s
epatientandlothersandadministeringPRNmedicationindiscriminatelyarenontherapeuticint
ss s
erventions. Usinglbehaviormodificationltodecrease the frequencyofhallucinationslwouldnee
s s ss ss ss
dtobeincorporatedintotheplanofcarelbythecareteam.
ss
DIF: Cognitivellevel: Applying ss
TOP: Nursingprocess:ImplementationMSC: ClientlNeeds:Safe,EffectiveCa
ss s ss s s s
ss reEnvironment
s
4. An adultldiagnosedwith chronicldepressionishospitalizedafterasuicidelattempt. Whichinte
ss ss ss
rventionliscriticalinassuringllong-
ss s s
term,effectiveclientcareasldescribedbypsychotherapeuticmanagement?
s s s s
a. Involvementingrouptherapies
b. Focusofcloselsupervisionbythelunitlstaff s
c. Maintainingeffectivecommunicationwithsupportsystem
d. Frequentlyscheduledlone-on-oneltimewithnursinglstaff
ANS: D ss
Acriticallelementofpsychotherapeuticmanagementlisthepresenceofatherapeutic s s
s nurse-patientrelationship.One-on-
s s s
onetimelwithnursinglstaffwillhelplinestablishingthislconnection.Whiletheotheroptionsare s
appropriateandlclientcentered,thenurse-clientrelationiscriticali n l the l longN
-s s s s s s
RSdeIliNveGrT
teUrm
ss yB
of.qC
uaOliM
tyeffectivecaretothislclient. s
DIF: Cognitivellevel: Applying ss
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:PsychosocialInte
ss s ss s s s
grity
5. Apatient‟s haloperidol dosagelwaslreduced 2 weekslagotodecreasesideleffects. What asses
s ss s s s ss
smentquestiondemonstrateslthelnurse‟sunderstandingloftheresultingneedsoftheclient?
ss s
a. “Willyouhaveanydifficultygetting yourprescriptionlrefilled?” s s
b. “Have youbegunexperiencinganyformsofhallucinations?”
ss
c. “Whatdoyouexpect willoccursincethedosagelhasbeenreduced?” ss
d. “What can Ildo tohelp youmanagethisreductionlinlhaloperidol therapy?”
s ss s ss ss
ANS: B ss
It willbelnecessaryforthenurseltoassessforexacerbation ofthelpatient‟s symptoms ofpsychosis
ss ss ss ss
as well as foralesseningofsideeffects. Dosagedecreasemightleadtothereturnorworseningofp
ss ss ss ss ss
ositivelsymptoms suchlas hallucinationslanddelusions, andnegativelsymptomslsuch as blunted af
ss ss ss ss ss ss ss
fect, socialwithdrawal, andpoorgrooming. Whiletheotheroptionsmaybelappropriatelassessme
ss ss ss ss
ntquestions, theyarelnot directed at thecurrentneeds oftheclient; thelidentification ofemerginglp
ss ss ss ss ss ss ss ss
sychoticbehaviors.
ss
DIF: Cognitivellevel: Analyzing ss
TOP: Nursingprocess:AssessmentMSC: ClientNeeds:PhysiologicIntegr
ss s ss s s s
ity
NURSINGTB.COM
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
Stuvia.com - The Marketplace to Buy and Sell your Study Material
6. Whichstatementformsthefoundationuponwhichanurseshouldbasetheimplementationofpsy s
s chotherapeuticmanagementltothelcarelofapatientwithlmentalillness?
s
a. Thenurse‟s roleinclientcareissupportedbythemultidisciplinaryteam.
s s s s
b. Omittinganyonecomponentwillcompromiseltheleffectivenessoftheltreatment.
c. Themostlimportantlelementofpsychotherapeuticmanagementlisdrugtherapy.
d. Atherapeuticnurse-patient relationshipisthemostimportantaspectoftreatment. s s
ANS: B ss
Whenoneelementismissing, treatmentisusuallycompromised. No singleelementlismoreimpo ss ss ss
rtantlthanlthelothers; however, patients‟ needslgovernlthelapplication ofthelcomponentsandperm
ss ss ss ss ss
it judiciousluse. Theremainingoptionsidentifycomponents ofthepsychotherapeuticmanageme
ss ss ss ss
ntprocess.
ss
DIF: Cognitivellevel:Analyzing
s s s s s
TOP: Nursingprocess:AnalysisMSC: ClientNeeds:Safe,EffectivelCa
ss s ss s s s
ss reEnvironment
s
7. Whichlstatementmostlaccuratelydescribesalnurse‟slrolelregarding psychopharmacology? ss
a. “YouwillneedtofrequentlymakedecisionsregardingtheadministrationofPRNme s
dicationstolhelplthelclientlmanageanger.”
s s
b. “It‟sanursinglresponsibilitytoadjust amedicationdoseltoassureleffectivelpatientresp
s s
onses.” ss
c. “Nursesadministersmedicationswhileevaluatingdrugleffectivenessislamedicalres
s
ponsibility.”
ss
d. “Tobestassureappropriateresponse,apatient‟squestionsaboutdrugtherapysho s s
uldbelreferredltolthelpsychiatrist.”
ss
ANS: A ss
Nursing l assessment and l analN isRoS
y sU f l dIaN
taGmTigBh.
t l sCuO
ggMest theneedforPRNmedicationaspatienta s s s
nxietyincreasesorpsychoticlsymptoms becomelmorelacute. Thelnurselis thehealth
ss ss ss ss
teammemberwholmakeslthisdetermination. Nursesareresponsibleformonitoringdrugleffective ss
ness aslwell as administeringmedication. Nurseslshould assumeresponsibilityforteachingpatien
ss ss ss ss ss ss
tslaboutlthelsideeffects ofmedications. Nurseslcannotalterprescribeddosagesofmedicationslunle
ss ss ss
sstheyhaveprescriptiveprivileges.
ss
DIF: Cognitivellevel:Analyzing
s s s s s
TOP: Nursingprocess:AnalysisMSC: ClientlNeeds:Safe,EffectivelCa
ss s ss s s
ss reEnvironment
s
8. Whenconsideringenvironmental aspectsofmilieulmanagement, whichlintervention hasthehig ss ss ss
hest priorityforaclient admittedlafteralfailed suicidelattempt?
ss ss ss ss
a. Sendingthelclient‟s newmedicationprescriptionslto thelpharmacy ss ss
b. Assigningastaffmembertoone-on-oneobservationofthelclient
c. Orientingltheclient tothemilieu‟slpublic andprivatespaces ss ss
d. Havinglall potentiallydangerousitemsremovedfromtheclient‟s belongings
s ss
ANS: B ss
Milieumanagementprovides alproactivelapproachtolcare. Safetyoverridesallotherdimension ss ss
softhelmilieu. Initiation of suicideprecautionsarethelpriorityforthisclient. Alltheremaininglo
ss ss ss ss ss
ptionsareappropriatebutlnoneprotecttheclientfromtheriskofanotherattemptltoself-
ss
harm asleffectivelyas one-on-onelobservationlas partofsuicideprecautions.
ss s ss ss
DIF: s s s s Cognitivellevel:Analyzing s TOP: Nursingprocess: Implementation
ss s
NURSINGTB.COM
ss ss ss ss ss ss ss ss ss ss
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
Stuvia.com - The Marketplace to Buy and Sell your Study Material
Chapter01:Med,Meds,Milieu
s s s s
Keltner:PsychiatricNursing,8thEdition
s s s
MULTIPLECHOICE
1. Anewlylicensedasksanursinglrecruiterforadescriptionofnursinglpracticelinthelpsyc s
s s hiatricsetting. Whatisthelnurselrecruiter‟s bestresponse?
s ss ss
a. “Thelnurselprimarilyservesinlasupportiveroletomembersofthehealthcaredeli s s
s s veryteam.”
b. “Themultidisciplinaryapproacheliminateslthelneedtolclearlydefineltheres
s s ponsibilitiesofnursinginsuchasetting.”
c. “Nursinglactionslarelidentifiedbytheinstitutionthatdistinguishesnursinglfromoth s
ss ermentallhealthprofessions.”
s s
d. “Nursingloffersluniquecontributionstothepsychotherapeuticmanagementofps s
ss ychiatricpatients.”
ANS: D ss
Professionalroleoverlap cannotlbedenied; however, nursingisluniquelinits focusonandlapplic
ss ss ss ss
ationlofpsychotherapeuticlmanagement.Neitherthelfacilitynorthelmultidisciplinaryteamdefi
ss s
netheprofessionalresponsibilitiesofitsmembersbutratherutilizestheiruniqueskillstolprovi
ss s s
s deholisticlcare. Ideally, all teamlmemberssupporteachlotherandhavefunctionswithinltheltea
s ss ss ss
m.
s s
DIF: Cognitivellevel: Analyzing ss
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:Safe,EffectivelCar
ss s ss s s s
ss elEnvironment
2. Which l component of the l nur sinUg pS
ro ceNs s w
Till theOnursefocusuponltoladdressltheres N R I G B.C M s s s
sponsibilitytolmatchindividualpatientneedswithappropriateservices? s
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: C ss
Properassessmentislcritical forbeinglabletodeterminetheappropriatelevelofservices thatlwill p ss ss ss
rovideoptimalcarelwhilelconsideringpatientinputand at thelowestlcost. Planningandimplement
ss ss ss s
ationlutilizeslthelassessment datalto identifyandexecuteactions(treatmentplan) thatwillprovide
ss ss s s
appropriatecare. Evaluation validatestheleffectiveness ofthetreatmentplan.
ss ss ss ss
DIF: Cognitivellevel: Applying ss
TOP: Nursingprocess:AssessmentlMSC: ClientNeeds:Safe,EffectiveCa
ss s ss s s s s
ss reEnvironment
s
3. An adultdiagnosedwithparanoidschizophreniafrequentlexperienceslauditoryhallucinationsan
ss
dwalksabouttheunit, muttering. Whichnursingactionldemonstratesthenurse‟s understandingl
ss ss ss ss
ofeffectivepsychotherapeuticmanagementofthisclient?
s s
a. Discussingthediseaseprocesslofschizophreniawiththeclientandltheirdomesticlpar s s
tner s s
b. Minimizingcontactbetweenthispatientandotherpatientstoassurelastressfreemili s
eu s s
c. Administering PRNmedicationwhenlfirstobservingtheevidencelthattheclient
s s
NURSINGTB.COM
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
Stuvia.com - The Marketplace to Buy and Sell your Study Material
maybehallucinating
d. Independentlydeterminingthatlbehaviormodificationlisappropriatetoldecreaseth
s s eclient‟slparanoidthoughts s
ANS: A ss
Anunderstandinglofpsychopathologyislthelfoundationonlwhichthethreecomponentsofpsyc
s
hotherapeuticlmanagementrest; it facilitates therapeuticcommunicationandprovidesabasis fo
ss ss s s ss
runderstandinglpsychopharmacologyandlmilieulmanagement.Minimizingcontactbetweenth
ss s s
epatientandlothersandadministeringPRNmedicationindiscriminatelyarenontherapeuticint
ss s
erventions. Usinglbehaviormodificationltodecrease the frequencyofhallucinationslwouldnee
s s ss ss ss
dtobeincorporatedintotheplanofcarelbythecareteam.
ss
DIF: Cognitivellevel: Applying ss
TOP: Nursingprocess:ImplementationMSC: ClientlNeeds:Safe,EffectiveCa
ss s ss s s s
ss reEnvironment
s
4. An adultldiagnosedwith chronicldepressionishospitalizedafterasuicidelattempt. Whichinte
ss ss ss
rventionliscriticalinassuringllong-
ss s s
term,effectiveclientcareasldescribedbypsychotherapeuticmanagement?
s s s s
a. Involvementingrouptherapies
b. Focusofcloselsupervisionbythelunitlstaff s
c. Maintainingeffectivecommunicationwithsupportsystem
d. Frequentlyscheduledlone-on-oneltimewithnursinglstaff
ANS: D ss
Acriticallelementofpsychotherapeuticmanagementlisthepresenceofatherapeutic s s
s nurse-patientrelationship.One-on-
s s s
onetimelwithnursinglstaffwillhelplinestablishingthislconnection.Whiletheotheroptionsare s
appropriateandlclientcentered,thenurse-clientrelationiscriticali n l the l longN
-s s s s s s
RSdeIliNveGrT
teUrm
ss yB
of.qC
uaOliM
tyeffectivecaretothislclient. s
DIF: Cognitivellevel: Applying ss
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:PsychosocialInte
ss s ss s s s
grity
5. Apatient‟s haloperidol dosagelwaslreduced 2 weekslagotodecreasesideleffects. What asses
s ss s s s ss
smentquestiondemonstrateslthelnurse‟sunderstandingloftheresultingneedsoftheclient?
ss s
a. “Willyouhaveanydifficultygetting yourprescriptionlrefilled?” s s
b. “Have youbegunexperiencinganyformsofhallucinations?”
ss
c. “Whatdoyouexpect willoccursincethedosagelhasbeenreduced?” ss
d. “What can Ildo tohelp youmanagethisreductionlinlhaloperidol therapy?”
s ss s ss ss
ANS: B ss
It willbelnecessaryforthenurseltoassessforexacerbation ofthelpatient‟s symptoms ofpsychosis
ss ss ss ss
as well as foralesseningofsideeffects. Dosagedecreasemightleadtothereturnorworseningofp
ss ss ss ss ss
ositivelsymptoms suchlas hallucinationslanddelusions, andnegativelsymptomslsuch as blunted af
ss ss ss ss ss ss ss
fect, socialwithdrawal, andpoorgrooming. Whiletheotheroptionsmaybelappropriatelassessme
ss ss ss ss
ntquestions, theyarelnot directed at thecurrentneeds oftheclient; thelidentification ofemerginglp
ss ss ss ss ss ss ss ss
sychoticbehaviors.
ss
DIF: Cognitivellevel: Analyzing ss
TOP: Nursingprocess:AssessmentMSC: ClientNeeds:PhysiologicIntegr
ss s ss s s s
ity
NURSINGTB.COM
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
Stuvia.com - The Marketplace to Buy and Sell your Study Material
6. Whichstatementformsthefoundationuponwhichanurseshouldbasetheimplementationofpsy s
s chotherapeuticmanagementltothelcarelofapatientwithlmentalillness?
s
a. Thenurse‟s roleinclientcareissupportedbythemultidisciplinaryteam.
s s s s
b. Omittinganyonecomponentwillcompromiseltheleffectivenessoftheltreatment.
c. Themostlimportantlelementofpsychotherapeuticmanagementlisdrugtherapy.
d. Atherapeuticnurse-patient relationshipisthemostimportantaspectoftreatment. s s
ANS: B ss
Whenoneelementismissing, treatmentisusuallycompromised. No singleelementlismoreimpo ss ss ss
rtantlthanlthelothers; however, patients‟ needslgovernlthelapplication ofthelcomponentsandperm
ss ss ss ss ss
it judiciousluse. Theremainingoptionsidentifycomponents ofthepsychotherapeuticmanageme
ss ss ss ss
ntprocess.
ss
DIF: Cognitivellevel:Analyzing
s s s s s
TOP: Nursingprocess:AnalysisMSC: ClientNeeds:Safe,EffectivelCa
ss s ss s s s
ss reEnvironment
s
7. Whichlstatementmostlaccuratelydescribesalnurse‟slrolelregarding psychopharmacology? ss
a. “YouwillneedtofrequentlymakedecisionsregardingtheadministrationofPRNme s
dicationstolhelplthelclientlmanageanger.”
s s
b. “It‟sanursinglresponsibilitytoadjust amedicationdoseltoassureleffectivelpatientresp
s s
onses.” ss
c. “Nursesadministersmedicationswhileevaluatingdrugleffectivenessislamedicalres
s
ponsibility.”
ss
d. “Tobestassureappropriateresponse,apatient‟squestionsaboutdrugtherapysho s s
uldbelreferredltolthelpsychiatrist.”
ss
ANS: A ss
Nursing l assessment and l analN isRoS
y sU f l dIaN
taGmTigBh.
t l sCuO
ggMest theneedforPRNmedicationaspatienta s s s
nxietyincreasesorpsychoticlsymptoms becomelmorelacute. Thelnurselis thehealth
ss ss ss ss
teammemberwholmakeslthisdetermination. Nursesareresponsibleformonitoringdrugleffective ss
ness aslwell as administeringmedication. Nurseslshould assumeresponsibilityforteachingpatien
ss ss ss ss ss ss
tslaboutlthelsideeffects ofmedications. Nurseslcannotalterprescribeddosagesofmedicationslunle
ss ss ss
sstheyhaveprescriptiveprivileges.
ss
DIF: Cognitivellevel:Analyzing
s s s s s
TOP: Nursingprocess:AnalysisMSC: ClientlNeeds:Safe,EffectivelCa
ss s ss s s
ss reEnvironment
s
8. Whenconsideringenvironmental aspectsofmilieulmanagement, whichlintervention hasthehig ss ss ss
hest priorityforaclient admittedlafteralfailed suicidelattempt?
ss ss ss ss
a. Sendingthelclient‟s newmedicationprescriptionslto thelpharmacy ss ss
b. Assigningastaffmembertoone-on-oneobservationofthelclient
c. Orientingltheclient tothemilieu‟slpublic andprivatespaces ss ss
d. Havinglall potentiallydangerousitemsremovedfromtheclient‟s belongings
s ss
ANS: B ss
Milieumanagementprovides alproactivelapproachtolcare. Safetyoverridesallotherdimension ss ss
softhelmilieu. Initiation of suicideprecautionsarethelpriorityforthisclient. Alltheremaininglo
ss ss ss ss ss
ptionsareappropriatebutlnoneprotecttheclientfromtheriskofanotherattemptltoself-
ss
harm asleffectivelyas one-on-onelobservationlas partofsuicideprecautions.
ss s ss ss
DIF: s s s s Cognitivellevel:Analyzing s TOP: Nursingprocess: Implementation
ss s
NURSINGTB.COM
