PSYCHIATRIC NURSING, 8TH EDITION BY NORMAN L. KELTNER AND DEBBIE STEELE TEST BANK

PSYCHIATRIC NURSING, 8TH EDITION BY
NORMAN L. KELTNER AND DEBBIE STEELE
TEST BANK ISBN 9780323479516

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Test Bank
Psychiatric Nursing 8th Edition Keltner Steele
Test Bank

100% Verified Answers.




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Chapter 01: Me, Meds, Milieu


MULTIPLE CHOICE

1. Select the best description of nursing practice in the psychiatric setting.
a. The nurse primarily serves in a supportive role to other members of the team.
b. The multidisciplinary approach eliminates the need to clearly define the
responsibilities of nursing.
c. Clearly differentiated nursing actions have been identified that distinguish nursing
from other professions.
d. Although professional role overlap exists, nursing offers unique contributions to
psychotherapeutic management.
ANS: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
application of psychotherapeutic management. Psychiatric social workers do not have
expertise in physical care. Ideally, all team members support each other.

DIF: Cognitive level: Applying REF: p. 3
TOP: Nursing process: Implementation MSC: NCLEX: Safe, Effective Care Environment

2. The primary element required to match individual patient needs with appropriate services is
proper:
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 the patient with optimal care at the lowest cost. The decision tree for the
continuum of care establishes this fact.

DIF: Cognitive level: Understanding REF: p. 7
TOP: Nursing process: Assessment MSC: NCLEX: Safe, Effective Care Environment

3. An adult with paranoid schizophrenia is hospitalized. This patient has frequent auditory
hallucinations and walks about the unit, muttering. To use psychotherapeutic management
effectively, it is most important for the nurse to:
a. understand the disease process of schizophrenia.
b. minimize contact between this patient and other patients.
c. administer PRN medication before interacting with the patient.
d. use behavior modification to decrease the frequency of hallucinations.
ANS: A




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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.

DIF: Cognitive level: Applying REF: pp. 1-2
TOP: Nursing process: Implementation MSC: NCLEX: Safe, Effective Care Environment

4. A depressed adult is hospitalized after a suicide attempt. The patient receives an
antidepressant medication, is closely supervised, attends a variety of group therapies and
activities, watches television during free time, and talks to visitors in the evening. Which
additional intervention is needed in the patient’s care?
a. Milieu therapy
b. Adequate drug therapy
c. Increased contact with significant others
d. Meaningful communication with nursing staff
ANS: D
Two of the three elements of psychotherapeutic management are present:
psychopharmacology and milieu management. There is no evidence that the
psychotherapeutic nurse–patient relationship exists. Maintaining contact with significant
others is not considered an element of the psychotherapeutic management model.

DIF: Cognitive level: Applying REF: pp. 1-2 TOP: Nursing process: Planning
MSC: NCLEX: Psychosocial Integrity

5. A patient attends outpatient programs at a community mental health center and meets with the
primary nurse regularly. Last week, the patient’s haloperidol (Haldol) dose was reduced from
5 mg to 2 mg daily to decrease side effects. The nurse will need to monitor changes in:
a. the activity schedule at the center.
b. the nature of the patient’s symptoms.
c. attention given to the patient by other staff.
d. balance among psychotherapeutic management elements.
ANS: B
It will be necessary for the nurse to assess for exacerbation of the patient’s symptoms of
psychosis as well as for an amelioration 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.

DIF: Cognitive level: Applying REF: p. 2
TOP: Nursing process: Assessment MSC: NCLEX: Physiologic Integrity

6. Which guideline should a nurse use when applying the components of psychotherapeutic
management to the care of a patient with mental illness?
a. The nurse’s role in milieu management is secondary to that of social work.
b. Omitting any one component usually will result in less effective treatment.
c. The most important element of psychotherapeutic management is drug therapy.
d. A therapeutic nurse–patient relationship is the most important aspect of treatment.



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