TESTBANK -KeltnersPsychiatricNursing,9th
x x x x x x
x Edition (Steele), x x
Chapters1 -36|AllChaptersComplete
x x x x x x x x
,
,Chapter 01: Med, Meds, Milieu
x x x x
Keltner: Psychiatric Nursing, 8thEdition
x x x x
MULTIPLE CHOICE x
1. A newlylicensed asks a nursing recruiter for a descriptionofnursing practice inthe
x x x x x x x x x x x x x x
psychiatric setting. What is the nurse recruiter‘s best response?
x x x x x x x x x
a. ―The nurse primarily serves in a supportive role to members ofthe health care
x x x x x x x x x x x x x
delivery team.‖ x
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
x x x x x x x x x
responsibilities ofnursing in such a setting.‖ x x x x x x
c. ―Nursing actions are identified by the institution that distinguishes nursing from
x x x x x x x x x x
other mental health professions.‖ x x x
d. ―Nursing offers unique contributions to the psychotherapeutic management of x x x x x x x x
psychiatric patients.‖ x
ANSWER: D x
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
x x x x x x x x x x x x x x
applicationofpsychotherapeutic management. Neitherthefacility northe multidisciplinaryteam
x x x x x x x x x x x
define the professional responsibilities of its members but rather utilizes their unique skills to
x x x x x x x x x x x x x x
provide holistic care. Ideally, all team members support each other and have functions within the
x x x x x x x x x x x x x x x
team.
x
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation x x x x x
MSC: Client Needs: Safe, EffectiveCareEnvironment
x x x x x x x
2. Whichcomponent ofthe nursing process willthe nurse focus uponto address the
x x x x x x x x x x x x x
responsibilityto match individualpatient needs withappropriate services?
x x x x x x x x x
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C x
Proper assessment is critical for being able to determine the appropriate level of services that will
x x x x x x x x x x x x x x x
provide optimal care while considering patient input and at the lowest cost. Planning and
x x x x x x x x x x x x x x
implementation utilizes the assessment data to identify and execute actions (treatment plan) that will
x x x x x x x x x x x x x x
provide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
x x x x x x x x x x x
DIF: Cognitive level: Applying TOP: Nursingprocess: Assessment x x x x x
MSC: Client Needs: Safe, EffectiveCareEnvironment
x x x x x x x
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
x x x x x x x x x x
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
x x x x x x x x x x x x x
effective psychotherapeutic management ofthis client?
x x x x x x
a. Discussing the disease process ofschizophrenia withthe client and their domestic x x x x x x x x x x x
partner
b. Minimizing contact betweenthispatient and other patients to assure a stress free x x x x x x x x x x x x
milieu
c. Administering PRN medicationwhen first observing the evidencethat the client x x x x x x x x x x
, maybehallucinating x x
d. Independentlydetermining that behavior modification isappropriateto decrease x x x x x x x x
the client‘s paranoid thoughts
x x x
ANSWER: A x
An understanding of psychopathology is the foundation on which the three components of
x x x x x x x x x x x x
psychotherapeutic management rest; it facilitatestherapeuticcommunicationand providesabasis for
x x x x x x x x x x x x
understanding psychopharmacology and milieu management. Minimizing contact between the
x x x x x x x x x
patient and others and administering PRN medication indiscriminately are nontherapeutic
x x x x x x x x x x
interventions. Using behavior modification to decrease the frequency of hallucinations would need to
x x x x x x x x x x x x x
be incorporatedinto the planofcare by the care team.
x x x x x x x x x x x
DIF: Cognitive level: Applying TOP: Nursing process: Implementation x x x x x
MSC: Client Needs: Safe, EffectiveCareEnvironment
x x x x x x x
4. Anadult diagnosed withchronic depression is hospitalized after a suicide attempt.Which
x x x x x x x x x x x x
intervention is critical in assuring long-term, effective client care as described by
x x x x x x x x x x x x
psychotherapeutic management?
x x
a. Involvement ingrouptherapies x x x
b. Focus ofclose supervision bythe unit staff x x x x x x x
c. Maintaining effective communicationwithsupport system x x x x x
d. Frequentlyscheduled one-on-one time withnursing staff x x x x x x
ANSWER: D x
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
x x x x x x x x x x x
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this x x x x x x x x x x x
connection. While the other options are appropriate and client centered, the nurse-client relation is
x x x x x x x x x x x x x x
criticalin the long-termdeliveryofqualityeffective care to this client.
x x x x x x x x x x x x
DIF: Cognitive level: Applying TOP: Nursing process: Implementation x x x x x
MSC: Client Needs: Psychosocial Integrity
x x x x x
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
x x x x x x x x x x x x x
assessment questiondemonstratesthe nurse‘sunderstanding ofthe resulting needsofthe
x x x x x x x x x x x x
client?
x
a. ―Will you have any difficultygetting your prescription refilled?‖
x x x x x x x x
b. ―Have you begun experiencing any forms of hallucinations?‖ x x x x x x x
c. ―What do you expect willoccur since the dosage has been reduced?‖ x x x x x x x x x x x
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ x x x x x x x x x x x x
ANSWER: B x
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
x x x x x x x x x x x x x x x x x
well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
x x x x x x x x x x x x x x x x x x
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
x x x x x x x x x x x x x
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
x x x x x x x x x x x x x
assessment questions,theyare not directed at the current needsofthe client;the identificationof
x x x x x x x x x x x x x x x x
emerging psychotic behaviors.
x x x
DIF: Cognitive level: Analyzing x x TOP: Nursingprocess: Assessment x x x
MSC: Client Needs: Physiologic Integrity
x x x x x
x x x x x x
x Edition (Steele), x x
Chapters1 -36|AllChaptersComplete
x x x x x x x x
,
,Chapter 01: Med, Meds, Milieu
x x x x
Keltner: Psychiatric Nursing, 8thEdition
x x x x
MULTIPLE CHOICE x
1. A newlylicensed asks a nursing recruiter for a descriptionofnursing practice inthe
x x x x x x x x x x x x x x
psychiatric setting. What is the nurse recruiter‘s best response?
x x x x x x x x x
a. ―The nurse primarily serves in a supportive role to members ofthe health care
x x x x x x x x x x x x x
delivery team.‖ x
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
x x x x x x x x x
responsibilities ofnursing in such a setting.‖ x x x x x x
c. ―Nursing actions are identified by the institution that distinguishes nursing from
x x x x x x x x x x
other mental health professions.‖ x x x
d. ―Nursing offers unique contributions to the psychotherapeutic management of x x x x x x x x
psychiatric patients.‖ x
ANSWER: D x
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
x x x x x x x x x x x x x x
applicationofpsychotherapeutic management. Neitherthefacility northe multidisciplinaryteam
x x x x x x x x x x x
define the professional responsibilities of its members but rather utilizes their unique skills to
x x x x x x x x x x x x x x
provide holistic care. Ideally, all team members support each other and have functions within the
x x x x x x x x x x x x x x x
team.
x
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation x x x x x
MSC: Client Needs: Safe, EffectiveCareEnvironment
x x x x x x x
2. Whichcomponent ofthe nursing process willthe nurse focus uponto address the
x x x x x x x x x x x x x
responsibilityto match individualpatient needs withappropriate services?
x x x x x x x x x
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C x
Proper assessment is critical for being able to determine the appropriate level of services that will
x x x x x x x x x x x x x x x
provide optimal care while considering patient input and at the lowest cost. Planning and
x x x x x x x x x x x x x x
implementation utilizes the assessment data to identify and execute actions (treatment plan) that will
x x x x x x x x x x x x x x
provide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
x x x x x x x x x x x
DIF: Cognitive level: Applying TOP: Nursingprocess: Assessment x x x x x
MSC: Client Needs: Safe, EffectiveCareEnvironment
x x x x x x x
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
x x x x x x x x x x
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
x x x x x x x x x x x x x
effective psychotherapeutic management ofthis client?
x x x x x x
a. Discussing the disease process ofschizophrenia withthe client and their domestic x x x x x x x x x x x
partner
b. Minimizing contact betweenthispatient and other patients to assure a stress free x x x x x x x x x x x x
milieu
c. Administering PRN medicationwhen first observing the evidencethat the client x x x x x x x x x x
, maybehallucinating x x
d. Independentlydetermining that behavior modification isappropriateto decrease x x x x x x x x
the client‘s paranoid thoughts
x x x
ANSWER: A x
An understanding of psychopathology is the foundation on which the three components of
x x x x x x x x x x x x
psychotherapeutic management rest; it facilitatestherapeuticcommunicationand providesabasis for
x x x x x x x x x x x x
understanding psychopharmacology and milieu management. Minimizing contact between the
x x x x x x x x x
patient and others and administering PRN medication indiscriminately are nontherapeutic
x x x x x x x x x x
interventions. Using behavior modification to decrease the frequency of hallucinations would need to
x x x x x x x x x x x x x
be incorporatedinto the planofcare by the care team.
x x x x x x x x x x x
DIF: Cognitive level: Applying TOP: Nursing process: Implementation x x x x x
MSC: Client Needs: Safe, EffectiveCareEnvironment
x x x x x x x
4. Anadult diagnosed withchronic depression is hospitalized after a suicide attempt.Which
x x x x x x x x x x x x
intervention is critical in assuring long-term, effective client care as described by
x x x x x x x x x x x x
psychotherapeutic management?
x x
a. Involvement ingrouptherapies x x x
b. Focus ofclose supervision bythe unit staff x x x x x x x
c. Maintaining effective communicationwithsupport system x x x x x
d. Frequentlyscheduled one-on-one time withnursing staff x x x x x x
ANSWER: D x
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
x x x x x x x x x x x
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this x x x x x x x x x x x
connection. While the other options are appropriate and client centered, the nurse-client relation is
x x x x x x x x x x x x x x
criticalin the long-termdeliveryofqualityeffective care to this client.
x x x x x x x x x x x x
DIF: Cognitive level: Applying TOP: Nursing process: Implementation x x x x x
MSC: Client Needs: Psychosocial Integrity
x x x x x
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
x x x x x x x x x x x x x
assessment questiondemonstratesthe nurse‘sunderstanding ofthe resulting needsofthe
x x x x x x x x x x x x
client?
x
a. ―Will you have any difficultygetting your prescription refilled?‖
x x x x x x x x
b. ―Have you begun experiencing any forms of hallucinations?‖ x x x x x x x
c. ―What do you expect willoccur since the dosage has been reduced?‖ x x x x x x x x x x x
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ x x x x x x x x x x x x
ANSWER: B x
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
x x x x x x x x x x x x x x x x x
well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
x x x x x x x x x x x x x x x x x x
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
x x x x x x x x x x x x x
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
x x x x x x x x x x x x x
assessment questions,theyare not directed at the current needsofthe client;the identificationof
x x x x x x x x x x x x x x x x
emerging psychotic behaviors.
x x x
DIF: Cognitive level: Analyzing x x TOP: Nursingprocess: Assessment x x x
MSC: Client Needs: Physiologic Integrity
x x x x x
