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Debbie Steele L
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All Chapters Fully Covered 1-36| Verified Questions & 100% Accurate
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Answers with Rationales for Exam Preparations| A+ PASS ASSURED
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, Chapter 01: Me, Meds, Milieu L
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1. A newly licensed nurse asks a nursing recruiter for a description of nursing practice in the psychiatric setting.
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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 delivery team.
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b. The multidisciplinary approach eliminates the need to clearly define the responsibilities of nursing in such a
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setting.
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c. Nursing actions are identified by the institution that distinguishes nursing from other mental health T L T L L
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Tprofessions.
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d. Nursing offers unique contributions to the psychotherapeutic management of psychiatric patients.
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T CORRECT ANSWER: D
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Professional role overlap cannot be denied; however, nursing is unique in its focus on and application of
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psychotherapeutic management. Neither the facility nor the multidisciplinary team define the professional
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responsibilities of its members but rather utilizes their unique skills to provide holistic care. Ideally, all team
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members support each other and have functions within the team.
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DIF: Cognitive level: Analyzing T L T L TOP: Nursing process: Implementation MSC: Client Needs: Safe,
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Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to address the responsibility to match
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individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
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T CORRECT ANSWER: C L
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Proper assessment is critical for being able to determine the appropriate level of services that will provide optimal
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care while considering patient input and at the lowest cost. Planning and implementation utilizes the assessment data
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to identify and execute actions (treatment plan) that will provide appropriate care. Evaluation validates the
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effectiveness of the treatment plan.
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DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: Client Needs: Safe, Effective Care T L L
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Environment
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3. An adult diagnosed with paranoid schizophrenia frequently experiences auditory hallucinations and walks about
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the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of effective psychotherapeutic
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Tmanagement of this client?
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a. Discussing the disease process of schizophrenia with the client and their domestic partner L
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,b. Minimizing contact between this patient and other patients to assure a stress-free milieu T L L
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c. Administering PRN medication when first observing the evidence that the client may be hallucinating L
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d. Independently determining that behavior modification is appropriate to decrease the client‘s paranoid T L L
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thoughts
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CORRECT ANSWER: A L
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An understanding of psychopathology is the foundation on which the three components of psychotherapeutic
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management rest; it facilitates therapeutic communication and provides a basis for understanding
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psychopharmacology and milieu management. Minimizing contact between the patient and others and administering
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PRN medication indiscriminately are nontherapeutic interventions. Using behavior modification to decrease the
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frequency of hallucinations would need to be incorporated into the plan of care by the care team.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: Client Needs: Safe, Effective L
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Care Environment
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4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which intervention is critical
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in assuring long-term, effective client care as described by psychotherapeutic management?
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a. Involvement in group therapies L
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b. Focus of close supervision by the unit staff T L T L T L T L L
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c. Maintaining effective communication with support system L
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d. Frequently scheduled one-on-one time with nursing staff T L T L L
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T CORRECT ANSWER: D
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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 establishing this connection. While the
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other options are appropriate and client centered, the nurse-client relation is critical in the long-term delivery of
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quality effective care to this client.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: Client Needs: Psychosocial L
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Integrity
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5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What assessment question
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demonstrates the nurse‘s understanding of the resulting needs of the client?
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a. Will you have any difficulty getting your prescription refilled?
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b. Have you begun experiencing any forms of hallucinations?
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c. What do you expect will occur since the dosage has been reduced?
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d. What can I do to help you manage this reduction in haloperidol therapy?
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T CORRECT ANSWER: B
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It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as well as for a
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Tlessening of side effects. Dosage 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, social withdrawal, and poor grooming.
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While the other options may be 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 T L T L TOP: Nursing process: Assessment MSC: Client Needs: Physiologic
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Integrity
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6. Which statement forms the foundation upon which a nurse should base the implementation of psychotherapeutic
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Tmanagement to the care of a patient with mental illness?
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a. The nurse‘s role in client care is supported by the multidisciplinary team.
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b. Omitting any one component will compromise the effectiveness of the treatment. L
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c. The most important element of psychotherapeutic management is drug therapy.
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d. A therapeutic nurse-patient relationship is the most important aspect of treatment.
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T CORRECT ANSWER: B
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When one element is missing, treatment is usually compromised. No single element is more important than the
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others; however, patients‘ needs govern the application of the components and permit judicious use. The remaining
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options identify components of the psychotherapeutic management process.
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DIF: Cognitive level: Analyzing T L T L TOP: Nursing process: Analysis MSC: Client Needs: Safe, Effective
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Care Environment
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7. Which statement most accurately describes a nurse‘s role regarding psychopharmacology?
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a. You will need to frequently make decisions regarding the administration of PRN medications to help the
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Tclient manage anger.
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b. It‘s a nursing responsibility to adjust a medication dose to assure effective patient responses.
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c. Nurses administers medications while evaluating drug effectiveness is a medical responsibility.
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d. To best assure appropriate response, a patient‘s questions about drug therapy should be referred to the
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psychiatrist.
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Nursing assessment and analysis of data might suggest the need for PRN medication as patient anxiety increases or
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psychotic symptoms become more 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 administering medication. Nurses should assume
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responsibility for teaching patients about the side effects of medications. Nurses cannot alter prescribed dosages of
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medications unless they have prescriptive privileges.
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DIF: Cognitive level: Analyzing T L T L TOP: Nursing process: Analysis MSC: Client Needs: Safe, Effective
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