Keltner’s Psychiatric Nursing 9th Edition Steele Test Bank Updated Latest 2025–2026 Comprehensive Exam Prep Resource for Psychiatric and Mental Health Nursing Mastery with Practice Questions, Detailed Solutions, and Real Exam Insights for Academic Success

Steele: Keltner’s Psychiatric Nursing, 9th Edition
Chapter 01: Me, Meds, Milieu


MULTIPLE
CHOICE
1. A newly licensed nurse asks a nursing recruiter for a description of nursing
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practice in the psychiatric setting. What is the nurse recruiter‘s best
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response?
a. ―The nurse primarily serves in a supportive role to members of the
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health care T


delivery team.‖ T



b. ―The multidisciplinary approach eliminates the need to clearly
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define the T


responsibilities of nursing in such a setting.‖ T T T T T T



c. ―Nursing actions are identified by the institution that distinguishes
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nursing from T


other mental health professions.‖
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d. ―Nursing offers unique contributions to the psychotherapeutic
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management of T



psychiatric patients.‖ T




ANS: D T




Professional role overlap cannot be denied; however, nursing is unique in its
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focus on and application of psychotherapeutic management. Neither the facility
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nor the multidisciplinary team define the professional responsibilities of its
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members but rather utilizes their unique skills to provide holistic care. Ideally, all
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team members support each other and have functions within the team.
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DIF: Cognitive level: Analyzing TOP: Nursing process:
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Implementation MSC: Client Needs: Safe, Effective Care T T T T T T T




Environment

2. Which component of the nursing process will the nurse focus upon to
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address the responsibility to match individual patient needs with
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appropriate services? T



a. Planning
b. Evaluation
c. Assessment
d. Implementati T



on
ANS: C T




Proper assessment is critical for being able to determine the appropriate level of
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services that will provide optimal care while considering patient input and at the
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,Steele: Keltner’s Psychiatric Nursing, 9th Edition
lowest cost. Planning and implementation utilizes the assessment data to identify
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and execute actions (treatment plan) that will provide appropriate care.
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Evaluation validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying TOP: Nursing process:
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Assessment MSC: Client Needs: Safe, Effective Care T T T T T T T




Environment

3. An adult diagnosed with paranoid schizophrenia frequently experiences
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auditory hallucinations and walks about the unit, muttering. Which nursing
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action demonstrates the nurse‘s understanding of effective psychotherapeutic
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management of this client? T T T



a. Discussing the disease process of schizophrenia with the client and their
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domestic
partner
b. Minimizing contact between this patient and other patients to assure a T T T T T T T T T T T



stress-free
milieu
c. Administering PRN medication when first observing the evidence that T T T T T T T T T


the client T



may be hallucinating T T




d. Independently determining that behavior modification is appropriate to T T T T T T T T



decrease
the client‘s paranoid thoughts
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ANS: A T




An understanding of psychopathology is the foundation on which the three
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components of psychotherapeutic management rest; it facilitates therapeutic
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communication and provides a basis for understanding psychopharmacology and T T T T T T T T T




milieu management. Minimizing contact between the patient and others and
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administering PRN medication indiscriminately are nontherapeutic T T T T T T




interventions. Using behavior modification to decrease the frequency of
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hallucinations would need to be incorporated into the plan of care by the care
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team.

DIF: Cognitive level: Applying TOP: Nursing process:
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Implementation MSC: Client Needs: Safe, Effective Care T T T T T T T




Environment

4. An adult diagnosed with chronic depression is hospitalized after a suicide
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attempt. Which intervention is critical in assuring long-term, effective client
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care as described by psychotherapeutic management?
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a. Involvement in group therapies

,Steele: Keltner’s Psychiatric Nursing, 9th Edition
b. Focus of close supervision by the unit staff
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c. Maintaining effective communication with T T T


support system T



d. Frequently scheduled one-on-one time with T T T T



nursing staff T




ANS: D T



A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on-one time with nursing staff will help in
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establishing this connection. While the other options are appropriate and client
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centered, the nurse-client relation is critical in the long-term delivery of quality
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effective care to this client.
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DIF: Cognitive level: Applying TOP: Nursing process:
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Implementation MSC: Client Needs: Psychosocial Integrity T T T T T




5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
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effects. What assessment question demonstrates the nurse‘s understanding
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of the resulting needs of the client?
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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 T




It will be necessary for the nurse to assess for exacerbation of the patient‘s
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symptoms of psychosis as well as for a lessening of side effects. Dosage
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decrease might lead to the return or worsening of positive symptoms such as
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hallucinations and delusions, and negative symptoms such as blunted affect,
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social withdrawal, and poor grooming. While the other options may be
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appropriate assessment questions, they are not directed at the current needs of the
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client which is the identification of emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing TOP: Nursing process:
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Assessment MSC: Client Needs: Physiologic Integrity
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, Steele: Keltner’s Psychiatric Nursing, 9th Edition
6. Which statement forms the foundation upon which a nurse should base the
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implementation of psychotherapeutic management to the care of a patient with
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mental illness? T



a. The nurse‘s role in client care is supported by the multidisciplinary
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team.
b. Omitting any one component will compromise the effectiveness of the
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treatment.
c. The most important element of psychotherapeutic management is drug
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therapy.
d. A therapeutic nurse-patient relationship is the most important aspect of
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treatment.
ANS: B T




When one element is missing, treatment is usually compromised. No single
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element is more important than the others; however, patients‘ needs govern the
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application of the components and permit judicious use. The remaining options
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identify components of the psychotherapeutic management process.
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DIF: Cognitive level: Analyzing TOP: Nursing process:
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Analysis MSC: Client Needs: Safe, Effective Care
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Environment

7. Which statement most accurately describes a nurse‘s role regarding
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psychopharmacology?
a. ―You will need to frequently make decisions regarding the
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administration of PRN T T



medications to help the client manage anger.‖ T T T T T T



b. ―It‘s a nursing responsibility to adjust a medication dose to assure
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effective patient responses.‖ T T



c. ―Nurses administers medications while evaluating drug effectiveness
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is a medical responsibility.‖
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d. ―To best assure appropriate response, a patient‘s questions about
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drug therapy should be referred to the psychiatrist.‖
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ANS: A T




Nursing assessment and analysis of data might suggest the need for PRN
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medication as patient anxiety increases or psychotic symptoms become more
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acute. The nurse is the health team member who makes this determination.
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Nurses are responsible for monitoring drug effectiveness as well as
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administering medication. Nurses should assume responsibility for teaching
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patients about the side effects of medications. Nurses cannot alter prescribed
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dosages of medications unless they have prescriptive privileges.
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DIF: Cognitive level: Analyzing TOP: Nursing process:
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Analysis MSC: Client Needs: Safe, Effective Care
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Environment

8. When considering environmental aspects of milieu management, which
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intervention has the highest priority for a client admitted after a failed suicide
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