TEST BANK - Keltners Psychiatric Nursing, 9th Edition (Steele), Chapters 1 - 36 | All Chapters Complete

TEST BANK - Keltners Psychiatric Nursing, 9th
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33 Edition (Steele),
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Chapters 1 - 36 | All Chapters Complete
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,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8th Edition
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MULTIPLE CHOICE 33




1. A newly licensed asks a nursing recruiter for a description ofnursing practice inthe
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psychiatric setting. 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
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delivery team.‖ 33




b. ―The multidisciplinary approach eliminates the need to clearlydefine the
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responsibilities of nursing in such a setting.‖ 33 33 33 33 33 33




c. ―Nursing actions are identified by the institution that distinguishes nursing from 33 33 33 33 33 33 33 3 3 33 33




other mental health professions.‖ 3 3 33 33




d. ―Nursing offers unique contributions to the psychotherapeutic management of 33 33 33 33 33 33 33 33




psychiatric patients.‖ 3 3




ANSWER: D 3 3




Professional role overlap cannot be denied; however, nursing is unique in its focus on and 33 33 33 33 33 33 33 33 33 33 33 33 33 33




applicationofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
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define the professional responsibilities of its members but rather utilizes their unique skills to
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provide holistic care. Ideally, all team members support each other and have functions within the
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team.
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DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation 33 33 3 3 33 33




MSC: Client Needs: Safe, Effective Care Environment
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2. Which component ofthe nursing process willthe nurse focus upon to address the
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responsibility to match individualpatient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C 3 3




Proper assessment is critical for being able to determine the appropriate level of services that will
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provide optimal care while considering patient input and at the lowest cost. Planning and
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implementation utilizes the assessment data to identify and execute actions (treatment plan) that
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willprovide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
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DIF: Cognitive level: Applying TOP: Nursing process: Assessment 33 33 3 3 33 33




MSC: Client Needs: Safe, Effective Care Environment
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3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
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walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
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effective psychotherapeutic management of this client?
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a. Discussing the disease process of schizophrenia withthe client and their domestic 33 33 33 33 33 33 3 33 33 33 33




partner
b. Minimizing contact betweenthis patient and other patients to assure a stress free 33 33 33 33 33 33 33 33 33 33 33 33




milieu
c. Administering PRN medicationwhen first observing the evidence that the client 33 33 33 33 33 33 33 33 33 33

, may be hallucinating 33 33




d. Independentlydetermining that behavior modification is appropriateto decrease 3 33 33 33 33 33 33 33




the client‘s paranoid thoughts
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ANSWER: A 3 3




An understanding of psychopathology is the foundation on which the three components of
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psychotherapeutic management rest; it facilitates therapeutic communicationand provides abasis
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for understanding psychopharmacology and milieu management. Minimizing contact between the
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patient and others and administering PRN medication indiscriminately are nontherapeutic
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interventions. Using behavior modification to decrease the frequency of hallucinations would need
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to be incorporated into the plan ofcare by the care team.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation 33 33 3 3 33 33




MSC: Client Needs: Safe, Effective Care Environment
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4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
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intervention is critical in assuring long-term, effective client care as described by
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psychotherapeutic management?
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a. Involvement ingroup therapies 33 33 33




b. Focus of close supervision by the unit staff 33 33 33 33 33 33 33




c. Maintaining effective communicationwith support system 33 33 33 33 33




d. Frequentlyscheduled one-on-one time with nursing staff 33 33 33 33 33 33




ANSWER: D 3 3




Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
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nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this 33 33 33 33 33 33 33 33 33 33 33




connection. While the other options are appropriate and client centered, the nurse-client relation is
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critical in the long-termdeliveryofqualityeffective care to this client.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation 33 33 3 3 33 33




MSC: Client Needs: Psychosocial Integrity
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5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
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assessment questiondemonstratesthe nurse‘s understanding ofthe resulting needs ofthe
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client?
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a. ―Will you have any difficultygetting your prescription refilled?‖33 33 33 33 33 33 33 33




b. ―Have you begun experiencing any forms of hallucinations?‖ 33 33 33 33 33 33 33




c. ―What do you expect willoccur since the dosage has been reduced?‖ 33 33 33 33 33 33 33 33 33 33 33




d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ 33 33 33 33 33 33 33 33 33 33 33 33




ANSWER: B 3 3




It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
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as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
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positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
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affect, social withdrawal, and poor grooming. While the other options maybe appropriate
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assessment questions, theyare not directed at the current needs ofthe client; the identification of
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emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment 33 33 3 3 33 33




MSC: Client Needs: Physiologic Integrity
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