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. Whichajcomponentajofajtheajnursingajprocessajwillajtheaj nurseajfocusajuponajtoajaddressajt
hejra esponsibilityajtoajmatchajindividualajpatientaj needsajwithajappropriateajservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER:a j C
Properajassessmentajisajcriticalajforajbeingajableajtoajdetermineajtheajappropriateajlevelajofajservicesajtha
tajwillajprovideajoptimalajcareajwhileajconsideringajpatientajinputajandajatajtheajlowestajcost.ajPlanningaja
ndajimplementationajutilizesajtheajassessmentajdataajtoajidentifyajandajexecuteajactionsaj(treatmentajpla
n)ajthatajwillajprovideajappropriateajcare.ajEvaluationajvalidatesajtheajeffectivenessajofajtheajtreatmentajp
lan.
DIF: Cognitiveajlevel:ajApplying
TOP:a j Nursingajprocess:ajAssessmentjM
a SC:a j ClientajNeeds:ajSafe,ajEffectiv
eajCareajEnvironment
3. Anajadultajdiagnosedajwithajparanoidajschizophreniaajfrequentajexperiencesajauditoryajhallucination
sjaa ndajwalksajaboutajtheajunit,ajmuttering.ajWhichajnursingajactionajdemonstratesajtheajnurse‘sajunder
standingajofajeffectiveajpsychotherapeuticaj managementajofajthisajclient?
a. Discussingajtheajdiseaseajprocessajofajschizophreniaajwithajtheajclientajandajtheirajdomestic
partner
b. Minimizingajcontactajbetweenajthisajpatientajandajotherajpatientsajtoajassureajaajstressajfree
milieu
c. AdministeringajPRNajmedicationajwhenajfirstajobservingajtheajevidenceajthatajtheajclient
, mayajbeajhallucinating
d. Independentlyajdeterminingajthatajbehaviorajmodificationajisajappropriateajtoajdecrease
theajclient‘sajparanoidajthoughts
ANSWER:a j A
Anajunderstandingajofajpsychopathologyajisajtheajfoundationajonajwhichajtheajthreeajcomponentsajofajpsy
chotherapeuticajmanagementajrest;ajitajfacilitatesajtherapeuticajcommunicationajandajprovidesajajabasisajf
orajunderstandingajpsychopharmacologyajandajmilieuajmanagement.ajMinimizingajcontactajbetweenajt
heajpatientajandajothersajandajadministeringajPRNajmedicationajindiscriminatelyajareajnontherapeuticaji
nterventions.ajUsingajbehaviorajmodificationajtoajdecreaseajtheajfrequencyajofajhallucinationsajwouldajn
eedajtoajbeajincorporatedajintoajtheajplanajofajcareajbyajtheajcareajteam.
DIF: Cognitiveajlevel:ajApplying
TOP:a j Nursingajprocess:ajImplementationjM
a SC:a j ClientajNeeds:ajSafe,ajEffectiv
eajCareajEnvironment
4. Anajadultajdiagnosedajwithajchronicajdepressionajisajhospitalizedajafterajaajsuicideajattempt.ajWhic
hjainterventionajisajcriticalajinajassuringajlong-
term,ajeffectiveajclientajcareajasajdescribedajbyajpsychotherapeuticaj management?
a. Involvement ajinajgroupajtherapies
b. Focusajofajcloseajsupervisionajbyajtheajunitaj staff
c. Maintainingajeffectiveajcommunicationajwithajsupportajsystem
d. Frequentlyajscheduledajone-on-oneajtimeajwithajnursingajstaff
ANSWER:a j D
Aajcriticalajelementajofajpsychotherapeuticajmanagementajisajtheajpresenceajofajaajtherapeutic
nurse-patientajrelationship.ajOne-on-
oneajtimeajwithajnursingajstaffajwillajhelpajinajestablishingajthisjaconnection.ajWhileajtheajotherajoptionsaj
areajappropriateajandajclientajcentered,ajtheajnurse-clientajrelationajisajcriticalajinajtheaj long-
termajdeliveryajofajqualityajeffectiveajcareajtoajthisajclient.
DIF: Cognitiveajlevel:ajApplying
TOP:a j Nursingajprocess:ajImplementationjM
a SC:a j ClientajNeeds:ajPsychosocialaj
Integrity
5. Aajpatient‘sajhaloperidolajdosageajwasajreducedaj2ajweeksajagoajtoajdecreaseajsideajeffects.ajWhat
assessmentajquestionajdemonstratesajtheajnurse‘sajunderstandingajofajtheajresultingajneedsajofajt
aj
hejca lient?
a. ―Willajyouajhaveajanyajdifficultyajgettingaj yourajprescriptionajrefilled?‖
b. ―Haveaj youajbegunajexperiencingajanyajformsajofajhallucinations?‖
c. ―Whatajdoajyouajexpectajwillajoccurajsinceajtheajdosageajhasajbeenajreduced?‖
d. ―WhatajcanajIajdoajtoajhelpaj youaj manageajthisajreductionajinajhaloperidolajtherapy?‖
ANSWER:a j B
Itajwillajbeajnecessaryajforajtheajnurseajtoajassessajforajexacerbationajofajtheajpatient‘sajsymptomsajofajps
ychosisajasajwellajasajforajaajlesseningajofajsideajeffects.ajDosageajdecreaseajmightajleadajtoajtheajreturnajo
rajworseningajofajpositiveajsymptomsajsuchajasajhallucinationsajandajdelusions,ajandajnegativeajsympt
omsajsuchajasajbluntedajaffect,ajsocialajwithdrawal,ajandajpoorajgrooming.ajWhileajtheajotherajoptionsaj
mayajbeajappropriateajassessmentajquestions,ajtheyajareajnotajdirectedajatajtheajcurrentajneedsajofjatheajcli
ent;ajtheajidentificationajofajemergingajpsychoticajbehaviors.
DIF: Cognitiveajlevel:ajAnalyzing
TOP:a j Nursingajprocess:ajAssessmentjM
a SC:a j ClientajNeeds:ajPhysiologicajI
ntegrity