TEST BANK - Keltners Psychiatric Nursing,
IIll IIll IIll IIll IIll
IIll9th Edition (Steele), IIll IIll IIll
Chapters 1 - 36 | All Chapters Complete
IIll IIll IIll IIll IIll IIll IIll IIll
,
,Chapter 01: Med, Meds, Milieu
IIll IIll IIll IIll
Keltner: Psychiatric Nursing, 8th Edition
IIll IIll IIll IIll
MULTIPLE CHOICE IIll
1. A newly licensed asks a nursing recruiter for a description of nursing practice in
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
thepsychiatric setting. What is the nurse recruiter‘s best response?
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll
a. ―The nurse primarily serves in a supportive role to members of the health care
IIll IIll IIll II ll IIll IIll IIll IIll IIll IIll IIll IIll IIll
delivery team.‖ I I ll
b. ―The multidisciplinary approach eliminates the need to clearly define the
IIll IIll IIll IIll IIll IIll I Ill IIll IIll
responsibilities of nursing in such a setting.‖ IIll IIll IIll II ll IIll IIll
c. ―Nursing actions are identified by the institution that distinguishes nursing IIll IIll IIll IIll IIll IIll IIll I I ll IIll
from I I ll
other mental health professions.‖ II ll IIll IIll
d. ―Nursing offers unique contributions to the psychotherapeutic management of IIll IIll IIll IIll IIll IIll I I ll IIll
psychiatric patients.‖ IIll
ANSWER: D IIll
Professional role overlap cannot be denied; however, nursing is unique in its focus on
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
and application of psychotherapeutic management. Neither the facility nor the
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
multidisciplinaryteam define the professional responsibilities of its members but rather
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll
utilizes their unique skills to provide holistic care. Ideally, all team members support
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
each other and have functions within the team.
IIll IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Analyzing TOP: Nursing process: IIll IIll I I l l IIll
ImplementationMSC: Client Needs: Safe, Effective Care Environment
IIll Il I I l l IIll IIll IIll IIll IIll
2. Which component of the nursing process will the nurse focus upon to address
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
theresponsibility to match individual patient needs with appropriate services?
IIll Il IIll IIll IIll IIll I I ll IIll IIll IIll
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C IIll
Proper assessment is critical for being able to determine the appropriate level of services
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
that will provide optimal care while considering patient input and at the lowest cost.
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
Planning and implementation utilizes the assessment data to identify and execute actions
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
(treatment plan) that will provide appropriate care. Evaluation validates the effectiveness of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
the treatment plan.
IIll IIll IIll
DIF: Cognitive level: Applying TOP: Nursing process: IIll IIll I I l l IIll
AssessmentMSC: Client Needs: Safe, Effective Care Environment
IIll Il I I l l IIll IIll IIll IIll IIll
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory
IIll IIll IIll IIll IIll IIll IIll IIll
hallucinationsand walks about the unit, muttering. Which nursing action demonstrates the
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
nurse‘s understanding of effective psychotherapeutic management of this client?
IIll IIll IIll IIll IIll II ll I I ll IIll IIll
a. Discussing the disease process of schizophrenia with the client and their domestic IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
partner
b. Minimizing contact between this patient and other patients to assure a stress free IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
milieu
c. Administering PRN medication when first observing the evidence that the client IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
, may be hallucinating IIll IIll
d. Independently determining that behavior modification is appropriate to decrease IIll IIll IIll IIll IIll IIll IIll IIll
the client‘s paranoid thoughts
IIll IIll IIll
ANSWER: A IIll
An understanding of psychopathology is the foundation on which the three components of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
psychotherapeutic management rest; it facilitates therapeutic communication and provides
IIll IIll IIll IIll IIll IIll IIll IIll IIll
abasis for understanding psychopharmacology and milieu management. Minimizing contact
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll
between the patient and others and administering PRN medication indiscriminately are
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
nontherapeutic interventions. Using behavior modification to decrease the frequency of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
hallucinations would need to be incorporated into the plan of care by the care team.
IIll IIll IIll IIll II ll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Applying TOP: Nursing process: IIll IIll I I l l IIll
ImplementationMSC: Client Needs: Safe, Effective Care Environment
IIll Il I I l l IIll IIll IIll IIll IIll
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt.
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
Whichintervention is critical in assuring long-term, effective client care as described
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
by psychotherapeutic management?
IIll IIll II ll
a. Involvement in group therapies IIll IIll IIll
b. Focus of close supervision by the unit staff IIll IIll IIll IIll IIll IIll I I ll
c. Maintaining effective communication with support system IIll IIll IIll IIll IIll
d. Frequently scheduled one-on-one time with nursing staff IIll IIll IIll IIll IIll IIll
ANSWER: D IIll
A critical element of psychotherapeutic management is the presence of a therapeutic
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
nurse-patient relationship. One-on-one time with nursing staff will help in establishing IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
thisconnection. While the other options are appropriate and client centered, the nurse-
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
client relation is critical in the long-term delivery of quality effective care to this client.
IIll IIll IIll IIll IIll I I ll IIll IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Applying TOP: Nursing process: IIll IIll I I l l IIll
ImplementationMSC: Client Needs: Psychosocial Integrity
IIll Il I I l l IIll IIll IIll
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects.
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
What assessment question demonstrates the nurse‘s understanding of the resulting
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
needs of theclient?
IIll IIll IIll Il
a. ―Will you have any difficulty getting your prescription refilled?‖
IIll IIll IIll IIll IIll IIll IIll IIll
b. ―Have you begun experiencing any forms of hallucinations?‖ IIll IIll IIll IIll IIll IIll IIll
c. ―What do you expect will occur since the dosage has been reduced?‖ II ll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
d. ―What can I do to help you manage this reduction in haloperidol II ll IIll IIll IIll II ll I I ll I I ll IIll IIll IIll IIll
therapy?‖ IIll
ANSWER: B IIll
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
return or worsening of positive symptoms such as hallucinations and delusions, and
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
negative symptoms such as blunted affect, social withdrawal, and poor grooming. While
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
the other options may be appropriate assessment questions, they are not directed at the
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
current needs ofthe client; the identification of emerging psychotic behaviors.
IIll IIll IIll Il IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Analyzing TOP: Nursing process: IIll IIll I I l l IIll
AssessmentMSC: Client Needs: Physiologic Integrity
IIll Il I I l l IIll IIll IIll
IIll IIll IIll IIll IIll
IIll9th Edition (Steele), IIll IIll IIll
Chapters 1 - 36 | All Chapters Complete
IIll IIll IIll IIll IIll IIll IIll IIll
,
,Chapter 01: Med, Meds, Milieu
IIll IIll IIll IIll
Keltner: Psychiatric Nursing, 8th Edition
IIll IIll IIll IIll
MULTIPLE CHOICE IIll
1. A newly licensed asks a nursing recruiter for a description of nursing practice in
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
thepsychiatric setting. What is the nurse recruiter‘s best response?
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll
a. ―The nurse primarily serves in a supportive role to members of the health care
IIll IIll IIll II ll IIll IIll IIll IIll IIll IIll IIll IIll IIll
delivery team.‖ I I ll
b. ―The multidisciplinary approach eliminates the need to clearly define the
IIll IIll IIll IIll IIll IIll I Ill IIll IIll
responsibilities of nursing in such a setting.‖ IIll IIll IIll II ll IIll IIll
c. ―Nursing actions are identified by the institution that distinguishes nursing IIll IIll IIll IIll IIll IIll IIll I I ll IIll
from I I ll
other mental health professions.‖ II ll IIll IIll
d. ―Nursing offers unique contributions to the psychotherapeutic management of IIll IIll IIll IIll IIll IIll I I ll IIll
psychiatric patients.‖ IIll
ANSWER: D IIll
Professional role overlap cannot be denied; however, nursing is unique in its focus on
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
and application of psychotherapeutic management. Neither the facility nor the
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
multidisciplinaryteam define the professional responsibilities of its members but rather
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll
utilizes their unique skills to provide holistic care. Ideally, all team members support
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
each other and have functions within the team.
IIll IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Analyzing TOP: Nursing process: IIll IIll I I l l IIll
ImplementationMSC: Client Needs: Safe, Effective Care Environment
IIll Il I I l l IIll IIll IIll IIll IIll
2. Which component of the nursing process will the nurse focus upon to address
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
theresponsibility to match individual patient needs with appropriate services?
IIll Il IIll IIll IIll IIll I I ll IIll IIll IIll
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C IIll
Proper assessment is critical for being able to determine the appropriate level of services
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
that will provide optimal care while considering patient input and at the lowest cost.
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
Planning and implementation utilizes the assessment data to identify and execute actions
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
(treatment plan) that will provide appropriate care. Evaluation validates the effectiveness of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
the treatment plan.
IIll IIll IIll
DIF: Cognitive level: Applying TOP: Nursing process: IIll IIll I I l l IIll
AssessmentMSC: Client Needs: Safe, Effective Care Environment
IIll Il I I l l IIll IIll IIll IIll IIll
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory
IIll IIll IIll IIll IIll IIll IIll IIll
hallucinationsand walks about the unit, muttering. Which nursing action demonstrates the
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
nurse‘s understanding of effective psychotherapeutic management of this client?
IIll IIll IIll IIll IIll II ll I I ll IIll IIll
a. Discussing the disease process of schizophrenia with the client and their domestic IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
partner
b. Minimizing contact between this patient and other patients to assure a stress free IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
milieu
c. Administering PRN medication when first observing the evidence that the client IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
, may be hallucinating IIll IIll
d. Independently determining that behavior modification is appropriate to decrease IIll IIll IIll IIll IIll IIll IIll IIll
the client‘s paranoid thoughts
IIll IIll IIll
ANSWER: A IIll
An understanding of psychopathology is the foundation on which the three components of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
psychotherapeutic management rest; it facilitates therapeutic communication and provides
IIll IIll IIll IIll IIll IIll IIll IIll IIll
abasis for understanding psychopharmacology and milieu management. Minimizing contact
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll
between the patient and others and administering PRN medication indiscriminately are
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
nontherapeutic interventions. Using behavior modification to decrease the frequency of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
hallucinations would need to be incorporated into the plan of care by the care team.
IIll IIll IIll IIll II ll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Applying TOP: Nursing process: IIll IIll I I l l IIll
ImplementationMSC: Client Needs: Safe, Effective Care Environment
IIll Il I I l l IIll IIll IIll IIll IIll
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt.
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
Whichintervention is critical in assuring long-term, effective client care as described
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
by psychotherapeutic management?
IIll IIll II ll
a. Involvement in group therapies IIll IIll IIll
b. Focus of close supervision by the unit staff IIll IIll IIll IIll IIll IIll I I ll
c. Maintaining effective communication with support system IIll IIll IIll IIll IIll
d. Frequently scheduled one-on-one time with nursing staff IIll IIll IIll IIll IIll IIll
ANSWER: D IIll
A critical element of psychotherapeutic management is the presence of a therapeutic
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
nurse-patient relationship. One-on-one time with nursing staff will help in establishing IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
thisconnection. While the other options are appropriate and client centered, the nurse-
IIll Il IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
client relation is critical in the long-term delivery of quality effective care to this client.
IIll IIll IIll IIll IIll I I ll IIll IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Applying TOP: Nursing process: IIll IIll I I l l IIll
ImplementationMSC: Client Needs: Psychosocial Integrity
IIll Il I I l l IIll IIll IIll
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects.
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
What assessment question demonstrates the nurse‘s understanding of the resulting
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
needs of theclient?
IIll IIll IIll Il
a. ―Will you have any difficulty getting your prescription refilled?‖
IIll IIll IIll IIll IIll IIll IIll IIll
b. ―Have you begun experiencing any forms of hallucinations?‖ IIll IIll IIll IIll IIll IIll IIll
c. ―What do you expect will occur since the dosage has been reduced?‖ II ll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
d. ―What can I do to help you manage this reduction in haloperidol II ll IIll IIll IIll II ll I I ll I I ll IIll IIll IIll IIll
therapy?‖ IIll
ANSWER: B IIll
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
return or worsening of positive symptoms such as hallucinations and delusions, and
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
negative symptoms such as blunted affect, social withdrawal, and poor grooming. While
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
the other options may be appropriate assessment questions, they are not directed at the
IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll IIll
current needs ofthe client; the identification of emerging psychotic behaviors.
IIll IIll IIll Il IIll IIll IIll IIll IIll IIll IIll
DIF: Cognitive level: Analyzing TOP: Nursing process: IIll IIll I I l l IIll
AssessmentMSC: Client Needs: Physiologic Integrity
IIll Il I I l l IIll IIll IIll
