TEST BANK - Keltners Psychiatric Nursing,
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A newly licensed 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.‖
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
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
3. An adult diagnosed with paranoid schizophrenia frequent 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
, maynbenhallucinating
d. Independentlyndeterminingnthatnbehaviornmodificationnisnappropriatentondecrease
thenclient‘snparanoidnthoughts
ANSWER:n A
Annunderstandingnofnpsychopathologynisnthenfoundationnonnwhichnthenthreencomponentsnofnpsyc
hotherapeuticnmanagementnrest;nitnfacilitatesntherapeuticncommunicationnandnprovidesnanbasisnfor
nunderstandingnpsychopharmacologynandnmilieunmanagement.nMinimizingncontactnbetweennthen
patientnandnothersnandnadministeringnPRNnmedicationnindiscriminatelynarennontherapeuticninterv
entions.nUsingnbehaviornmodificationntondecreasenthenfrequencynofnhallucinationsnwouldnneednton
benincorporatednintonthenplannofncarenbynthencarenteam.
DIF: Cognitivenlevel:nApplying
TOP:n Nursingnprocess:nImplementationnMSC:n ClientnNeeds:nSafe,nEffectiven
CarenEnvironment
4. Annadultndiagnosednwithnchronicndepressionnisnhospitalizednafternansuicidenattempt.nWhichn
interventionnisncriticalninnassuringnlong-
term,neffectivenclientncarenasndescribednbynpsychotherapeuticnmanagement?
a. Involvementninngroupntherapies
b. Focusnofnclosensupervisionnbynthenunitn staff
c. Maintainingneffectivencommunicationnwithnsupportnsystem
d. Frequentlynschedulednone-on-onentimenwithnnursingnstaff
ANSWER:n D
Ancriticalnelementnofnpsychotherapeuticnmanagementnisnthenpresencenofnantherapeutic
nurse-patientnrelationship.nOne-on-
onentimenwithnnursingnstaffnwillnhelpninnestablishingnthisnconnection.nWhilenthenothernoptionsnar
enappropriatenandnclientncentered,nthennurse-clientnrelationnisncriticalninnthen long-
termndeliverynofnqualityneffectivencarentonthisnclient.
DIF: Cognitivenlevel:nApplying
TOP:n Nursingnprocess:nImplementationnMSC:n ClientnNeeds:nPsychosocialnIn
tegrity
5. Anpatient‘snhaloperidolndosagenwasnreducedn2nweeksnagontondecreasensideneffects.nWhatn
assessmentnquestionndemonstratesnthennurse‘snunderstandingnofnthenresultingnneedsnofnthen
client?
a. ―Willnyounhavenanyndifficultyngettingn yournprescriptionnrefilled?‖
b. ―Haven younbegunnexperiencingnanynformsnofnhallucinations?‖
c. ―Whatn donyounexpectn willnoccurnsincenthendosagenhasnbeennreduced?‖
d. ―Whatn cannIndonton helpn youn managenthisnreductionninnhaloperidolntherapy?‖
ANSWER:n B
Itnwillnbennecessarynfornthennursentonassessnfornexacerbationnofnthenpatient‘snsymptomsnofnpsyc
hosisnasnwellnasnfornanlesseningnofnsideneffects.nDosagendecreasenmightnleadntonthenreturnnornwo
rseningnofnpositivensymptomsnsuchnasnhallucinationsnandndelusions,nandnnegativensymptomsns
uchnasnbluntednaffect,nsocialnwithdrawal,nandnpoorngrooming.nWhilenthenothernoptionsnmaynben
appropriatenassessmentnquestions,ntheynarennotndirectednatnthencurrentnneedsnofnthenclient;nthenid
entificationnofnemergingnpsychoticnbehaviors.
DIF: Cognitivenlevel:nAnalyzing
TOP:n Nursingnprocess:nAssessmentnMSC:n ClientnNeeds:nPhysiologicnInt
egrity
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A newly licensed 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.‖
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
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
3. An adult diagnosed with paranoid schizophrenia frequent 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
, maynbenhallucinating
d. Independentlyndeterminingnthatnbehaviornmodificationnisnappropriatentondecrease
thenclient‘snparanoidnthoughts
ANSWER:n A
Annunderstandingnofnpsychopathologynisnthenfoundationnonnwhichnthenthreencomponentsnofnpsyc
hotherapeuticnmanagementnrest;nitnfacilitatesntherapeuticncommunicationnandnprovidesnanbasisnfor
nunderstandingnpsychopharmacologynandnmilieunmanagement.nMinimizingncontactnbetweennthen
patientnandnothersnandnadministeringnPRNnmedicationnindiscriminatelynarennontherapeuticninterv
entions.nUsingnbehaviornmodificationntondecreasenthenfrequencynofnhallucinationsnwouldnneednton
benincorporatednintonthenplannofncarenbynthencarenteam.
DIF: Cognitivenlevel:nApplying
TOP:n Nursingnprocess:nImplementationnMSC:n ClientnNeeds:nSafe,nEffectiven
CarenEnvironment
4. Annadultndiagnosednwithnchronicndepressionnisnhospitalizednafternansuicidenattempt.nWhichn
interventionnisncriticalninnassuringnlong-
term,neffectivenclientncarenasndescribednbynpsychotherapeuticnmanagement?
a. Involvementninngroupntherapies
b. Focusnofnclosensupervisionnbynthenunitn staff
c. Maintainingneffectivencommunicationnwithnsupportnsystem
d. Frequentlynschedulednone-on-onentimenwithnnursingnstaff
ANSWER:n D
Ancriticalnelementnofnpsychotherapeuticnmanagementnisnthenpresencenofnantherapeutic
nurse-patientnrelationship.nOne-on-
onentimenwithnnursingnstaffnwillnhelpninnestablishingnthisnconnection.nWhilenthenothernoptionsnar
enappropriatenandnclientncentered,nthennurse-clientnrelationnisncriticalninnthen long-
termndeliverynofnqualityneffectivencarentonthisnclient.
DIF: Cognitivenlevel:nApplying
TOP:n Nursingnprocess:nImplementationnMSC:n ClientnNeeds:nPsychosocialnIn
tegrity
5. Anpatient‘snhaloperidolndosagenwasnreducedn2nweeksnagontondecreasensideneffects.nWhatn
assessmentnquestionndemonstratesnthennurse‘snunderstandingnofnthenresultingnneedsnofnthen
client?
a. ―Willnyounhavenanyndifficultyngettingn yournprescriptionnrefilled?‖
b. ―Haven younbegunnexperiencingnanynformsnofnhallucinations?‖
c. ―Whatn donyounexpectn willnoccurnsincenthendosagenhasnbeennreduced?‖
d. ―Whatn cannIndonton helpn youn managenthisnreductionninnhaloperidolntherapy?‖
ANSWER:n B
Itnwillnbennecessarynfornthennursentonassessnfornexacerbationnofnthenpatient‘snsymptomsnofnpsyc
hosisnasnwellnasnfornanlesseningnofnsideneffects.nDosagendecreasenmightnleadntonthenreturnnornwo
rseningnofnpositivensymptomsnsuchnasnhallucinationsnandndelusions,nandnnegativensymptomsns
uchnasnbluntednaffect,nsocialnwithdrawal,nandnpoorngrooming.nWhilenthenothernoptionsnmaynben
appropriatenassessmentnquestions,ntheynarennotndirectednatnthencurrentnneedsnofnthenclient;nthenid
entificationnofnemergingnpsychoticnbehaviors.
DIF: Cognitivenlevel:nAnalyzing
TOP:n Nursingnprocess:nAssessmentnMSC:n ClientnNeeds:nPhysiologicnInt
egrity
