Chapter 20: Introduction to Milieu Management
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. During orientation the clinical nurse leader tells a novice nurse, ―You will be involved in
purposeful creation of corrective learning experiences for all patients so as to provide a healing
atmosphere.‖ The clinical nurse leader is explaining aspects of which milieu-related concept?
a. Balance
b. Limit-setting
c. A therapeutic environment
d. Establishing behavioral norms
ANS: C
A therapeutic environment requires creation of corrective learning experiences to promote a
therapeutic atmosphere. Limit-setting, balance, and norms are individual elements of the
therapeutic environment and are answers that are too narrow.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Four nurses describe their unit environments. Which description can most clearly be identified as
therapeutic?
a. ―My unit uses behavior modification to enhance patients‘ social skills.‖
b. ―My unit allows patients to test new behaviors in a secure environment.‖
c. ―My unit helps patients deal with childhood issues by providing a safe setting.‖
d. ―My unit allows patients to deal with personal issues without interpersonal
stressors.‖
ANS: B
, The unit described in the correct answer provides a broad therapeutic focus for providing
corrective experiences that helps patients recover. The distracters are too narrow in their
therapeutic scope.
DIF: Cognitive level: Analyzing TOP: Nursing process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
3. Which nursing action best supports maintenance of a therapeutic environment?
a. Creating therapeutic relationships with patients
b. Providing purposeful structured activities c. Maintaining patient records and care plans d.
Administering medication
ANS: A
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. During orientation the clinical nurse leader tells a novice nurse, ―You will be involved in
purposeful creation of corrective learning experiences for all patients so as to provide a healing
atmosphere.‖ The clinical nurse leader is explaining aspects of which milieu-related concept?
a. Balance
b. Limit-setting
c. A therapeutic environment
d. Establishing behavioral norms
ANS: C
A therapeutic environment requires creation of corrective learning experiences to promote a
therapeutic atmosphere. Limit-setting, balance, and norms are individual elements of the
therapeutic environment and are answers that are too narrow.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Four nurses describe their unit environments. Which description can most clearly be identified as
therapeutic?
a. ―My unit uses behavior modification to enhance patients‘ social skills.‖
b. ―My unit allows patients to test new behaviors in a secure environment.‖
c. ―My unit helps patients deal with childhood issues by providing a safe setting.‖
d. ―My unit allows patients to deal with personal issues without interpersonal
stressors.‖
ANS: B
, The unit described in the correct answer provides a broad therapeutic focus for providing
corrective experiences that helps patients recover. The distracters are too narrow in their
therapeutic scope.
DIF: Cognitive level: Analyzing TOP: Nursing process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
3. Which nursing action best supports maintenance of a therapeutic environment?
a. Creating therapeutic relationships with patients
b. Providing purposeful structured activities c. Maintaining patient records and care plans d.
Administering medication
ANS: A
