, Psychiatric Nursing 8th Edition Test Bank
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?”
d. “What can I do to help you manage this reduction in haloperidol 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; the identification of emerging
psychotic behaviors.
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
dr.j
, Psychiatric Nursing 8th Edition Test Bank
MSC: Client Needs: Physiologic Integrity
6. Which statement forms the foundation upon which a nurse should base the implementation of
psychotherapeutic management to the care of a patient with mental illness?
a. The nurse’s role in client care is supported by the multidisciplinary team.
b. Omitting any one component will compromise the effectiveness of the 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.
ANS: B
When one element is missing, treatment is usually compromised. No single element is more important
than the others; however, patients’ needs govern the application of the components and permit
judicious use. The remaining options identify components of the psychotherapeutic management
process.
DIF: Cognitive level: Analyzing TOP: Nursing process: Analysis
MSC: Client Needs: Safe, Effective Care Environment
7. Which statement most accurately describes a nurse’s role regarding psychopharmacology?
a. “You will need to frequently make decisions regarding the administration of PRN
medications to help the client manage anger.”
b. “It’s a nursing responsibility to adjust a medication dose to assure effective patient
responses.”
c. “Nurses administers medications while evaluating drug effectiveness is a medical
responsibility.”
d. “To best assure appropriate response, a patient’s questions about drug therapy
should be referred to the psychiatrist.”
ANS: A
Nursing assessment and analysis of data might suggest the need for PRN medication as patient anxiety
increases or psychotic symptoms become more acute. The nurse is the health team member who makes
this determination. Nurses are responsible for monitoring drug effectiveness as well as administering
medication. Nurses should assume responsibility for teaching patients about the side effects of
medications. Nurses cannot alter prescribed dosages of medications unless they have prescriptive
privileges.
DIF: Cognitive level: Analyzing TOP: Nursing process: Analysis
MSC: Client Needs: Safe, Effective Care Environment
8. When considering environmental aspects of milieu management, which intervention has the highest
priority for a client admitted after a failed suicide attempt?
a. Sending the client’s new medication prescriptions to the pharmacy
b. Assigning a staff member to one-on-one observation of the client
c. Orienting the client to the milieu’s public and private spaces
d. Having all potentially dangerous items removed from the client’s belongings
ANS: B
dr.j
, Psychiatric Nursing 8th Edition Test Bank
Milieu management provides a proactive approach to care. Safety overrides all other dimensions of the
milieu. Initiation of suicide precautions are the priority for this client. All the remaining options are
appropriate but none protect the client from the risk of another attempt to self-harm as effectively as
one-on-one observation as part of suicide precautions.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
9. The implementation of which unit policy directed at milieu balance would reflect a need for
reconsideration on the part of the treatment team?
a. All clients will receive verbal and written information explaining unit rules.
b. Unit clients will engage in all unit activities to assure interaction with both staff
and other clients.
c. All clients will be uniformly expected to present themselves in a nonviolent
manner to both staff and other clients.
d. At times of unit stress, client will return to their rooms.
ANS: B
The situation described suggests a milieu in which patients have no time for planned therapeutic
encounters with staff; hence, it is a milieu lacking balance. The remaining options address unit norms,
limit setting, and environmental modifications that are reasonable and will contribute to a therapeutic
milieu.
DIF: Cognitive level: Evaluating TOP: Nursing process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
10. Which intervention should the nurse implement when focusing on communicating therapeutically with
a client?
a. Explaining to the client why they will need to ask for a razor
b. Providing the client with options to help achieve smoking cessation
c. Encouraging the client to identify personal stressors
d. Assuring the client that they can receive telephone call on the unit telephone
ANS: C
A nurse uses therapeutic communication techniques as part of the therapeutic nurse-patient
relationship. An example of such communication is providing the client with an opportunity to safely
identify personal stressors. The remaining options address safety, balance, and norms associated with
their care.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
11. During the risk assessment phase of care for a psychiatric patient, what is the nurse’s primary goal?
a. Making an initial assessment
b. Confirming the patient’s problem
c. Assessing potential dangerousness to self or others
d. Determining the level of supervision needed for the patient
ANS: C
dr.j
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?”
d. “What can I do to help you manage this reduction in haloperidol 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; the identification of emerging
psychotic behaviors.
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
dr.j
, Psychiatric Nursing 8th Edition Test Bank
MSC: Client Needs: Physiologic Integrity
6. Which statement forms the foundation upon which a nurse should base the implementation of
psychotherapeutic management to the care of a patient with mental illness?
a. The nurse’s role in client care is supported by the multidisciplinary team.
b. Omitting any one component will compromise the effectiveness of the 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.
ANS: B
When one element is missing, treatment is usually compromised. No single element is more important
than the others; however, patients’ needs govern the application of the components and permit
judicious use. The remaining options identify components of the psychotherapeutic management
process.
DIF: Cognitive level: Analyzing TOP: Nursing process: Analysis
MSC: Client Needs: Safe, Effective Care Environment
7. Which statement most accurately describes a nurse’s role regarding psychopharmacology?
a. “You will need to frequently make decisions regarding the administration of PRN
medications to help the client manage anger.”
b. “It’s a nursing responsibility to adjust a medication dose to assure effective patient
responses.”
c. “Nurses administers medications while evaluating drug effectiveness is a medical
responsibility.”
d. “To best assure appropriate response, a patient’s questions about drug therapy
should be referred to the psychiatrist.”
ANS: A
Nursing assessment and analysis of data might suggest the need for PRN medication as patient anxiety
increases or psychotic symptoms become more acute. The nurse is the health team member who makes
this determination. Nurses are responsible for monitoring drug effectiveness as well as administering
medication. Nurses should assume responsibility for teaching patients about the side effects of
medications. Nurses cannot alter prescribed dosages of medications unless they have prescriptive
privileges.
DIF: Cognitive level: Analyzing TOP: Nursing process: Analysis
MSC: Client Needs: Safe, Effective Care Environment
8. When considering environmental aspects of milieu management, which intervention has the highest
priority for a client admitted after a failed suicide attempt?
a. Sending the client’s new medication prescriptions to the pharmacy
b. Assigning a staff member to one-on-one observation of the client
c. Orienting the client to the milieu’s public and private spaces
d. Having all potentially dangerous items removed from the client’s belongings
ANS: B
dr.j
, Psychiatric Nursing 8th Edition Test Bank
Milieu management provides a proactive approach to care. Safety overrides all other dimensions of the
milieu. Initiation of suicide precautions are the priority for this client. All the remaining options are
appropriate but none protect the client from the risk of another attempt to self-harm as effectively as
one-on-one observation as part of suicide precautions.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
9. The implementation of which unit policy directed at milieu balance would reflect a need for
reconsideration on the part of the treatment team?
a. All clients will receive verbal and written information explaining unit rules.
b. Unit clients will engage in all unit activities to assure interaction with both staff
and other clients.
c. All clients will be uniformly expected to present themselves in a nonviolent
manner to both staff and other clients.
d. At times of unit stress, client will return to their rooms.
ANS: B
The situation described suggests a milieu in which patients have no time for planned therapeutic
encounters with staff; hence, it is a milieu lacking balance. The remaining options address unit norms,
limit setting, and environmental modifications that are reasonable and will contribute to a therapeutic
milieu.
DIF: Cognitive level: Evaluating TOP: Nursing process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
10. Which intervention should the nurse implement when focusing on communicating therapeutically with
a client?
a. Explaining to the client why they will need to ask for a razor
b. Providing the client with options to help achieve smoking cessation
c. Encouraging the client to identify personal stressors
d. Assuring the client that they can receive telephone call on the unit telephone
ANS: C
A nurse uses therapeutic communication techniques as part of the therapeutic nurse-patient
relationship. An example of such communication is providing the client with an opportunity to safely
identify personal stressors. The remaining options address safety, balance, and norms associated with
their care.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
11. During the risk assessment phase of care for a psychiatric patient, what is the nurse’s primary goal?
a. Making an initial assessment
b. Confirming the patient’s problem
c. Assessing potential dangerousness to self or others
d. Determining the level of supervision needed for the patient
ANS: C
dr.j
