Test Bank for Keltner’s
Psychiatric Nursing, 9th
Edition by Debbie
Steele |Chapter 1-36 |
All Chapters NEWEST
EDITION 2024|25
,Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed nurse 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
N
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.‖
ANS: 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
ANS: 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 frequently 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
may be hallucinating
d. Independently determining that behavior modification is appropriate to
decrease
the client‘s paranoid thoughts
ANS: A
An understanding of psychopathology is the foundation on which the three
components of psychotherapeutic management rest; it facilitates therapeutic
communication and provides a basis for understanding psychopharmacology and milieu
management. Minimizing contact between the patient and others and administering
PRN medication indiscriminately are nontherapeutic interventions. Using behavior
modification to decrease the frequency of hallucinations would need to be
incorporated into the plan of care by the care team.
DIF: Cognitive level: Applying TOP: Nursing process:
Implementation MSC: Client Needs: Safe, Effective Care Environment
4. An adult diagnosed with chronic depression is hospitalized after a suicide
attempt. Which intervention is critical in assuring long-term, effective client
care as described by psychotherapeutic management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining effective communication with support
system
d. Frequently scheduled one-on-one time with nursing
staff
ANS: D
A critical element of psychotherapeutic management is the presence of a therapeutic
nurse-patient relationship. One-on-one time with nursing staff will help in establishing
this connection. While the other options are appropriate and client centered, the
nurse-client relation is critical in the long-term delivery of quality effective care
to this client.
DIF: Cognitive level: Applying TOP: Nursing process:
Implementation MSC: Client Needs: Psychosocial Integrity
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
, effects. What assessment question demonstrates the nurse‘s understanding of the
resulting needs of the client?
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?‖
N N
d. —What can I do to help you manage this reduction in haloperidol
N
therapy?‖
ANS: B
It will be necessary for the nurse to assess for exacerbation of the patient‘s
symptoms of psychosis as well as for a lessening of side effects. Dosage
decrease might lead to the return or worsening of positive symptoms such as
hallucinations and delusions, and negative symptoms such as blunted affect, social
withdrawal, and poor grooming. While the other options may be appropriate
assessment questions, they are not directed at the current needs of the client which
is the identification of emerging psychotic behaviors.
DIF: Cognitive level: Analyzing TOP: Nursing process:
Assessment MSC: Client Needs: Physiologic Integrity
Psychiatric Nursing, 9th
Edition by Debbie
Steele |Chapter 1-36 |
All Chapters NEWEST
EDITION 2024|25
,Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed nurse 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
N
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.‖
ANS: 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
ANS: 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 frequently 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
may be hallucinating
d. Independently determining that behavior modification is appropriate to
decrease
the client‘s paranoid thoughts
ANS: A
An understanding of psychopathology is the foundation on which the three
components of psychotherapeutic management rest; it facilitates therapeutic
communication and provides a basis for understanding psychopharmacology and milieu
management. Minimizing contact between the patient and others and administering
PRN medication indiscriminately are nontherapeutic interventions. Using behavior
modification to decrease the frequency of hallucinations would need to be
incorporated into the plan of care by the care team.
DIF: Cognitive level: Applying TOP: Nursing process:
Implementation MSC: Client Needs: Safe, Effective Care Environment
4. An adult diagnosed with chronic depression is hospitalized after a suicide
attempt. Which intervention is critical in assuring long-term, effective client
care as described by psychotherapeutic management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining effective communication with support
system
d. Frequently scheduled one-on-one time with nursing
staff
ANS: D
A critical element of psychotherapeutic management is the presence of a therapeutic
nurse-patient relationship. One-on-one time with nursing staff will help in establishing
this connection. While the other options are appropriate and client centered, the
nurse-client relation is critical in the long-term delivery of quality effective care
to this client.
DIF: Cognitive level: Applying TOP: Nursing process:
Implementation MSC: Client Needs: Psychosocial Integrity
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
, effects. What assessment question demonstrates the nurse‘s understanding of the
resulting needs of the client?
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?‖
N N
d. —What can I do to help you manage this reduction in haloperidol
N
therapy?‖
ANS: B
It will be necessary for the nurse to assess for exacerbation of the patient‘s
symptoms of psychosis as well as for a lessening of side effects. Dosage
decrease might lead to the return or worsening of positive symptoms such as
hallucinations and delusions, and negative symptoms such as blunted affect, social
withdrawal, and poor grooming. While the other options may be appropriate
assessment questions, they are not directed at the current needs of the client which
is the identification of emerging psychotic behaviors.
DIF: Cognitive level: Analyzing TOP: Nursing process:
Assessment MSC: Client Needs: Physiologic Integrity
