TEST BANK - Keltners Psychiatric Nursing,
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
psychiatric setting. What is the nurse recruiter‘s best response?
a. ―The nurse primarily serves in a supportive role to members of the health care
delivery team.‖
b. ―The multidisciplinary approach eliminates the need to clearly define the
responsibilities of nursing in such a setting.‖
c. ―Nursing actions are identified by the institution that distinguishes nursing from
other mental health professions.‖
d. ―Nursing offers unique contributions to the psychotherapeutic management of
psychiatric patients.‖
ANSWER: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
application of psychotherapeutic management. Neither the facility nor the multidisciplinary
team define the professional responsibilities of its members but rather utilizes their unique
skills to provide holistic care. Ideally, all team members support each other and have
functions within the team.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Which component of the nursing process will the nurse focus upon to address the
responsibility to match individual patient needs with appropriate services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C
Proper assessment is critical for being able to determine the appropriate level of services that
will provide optimal care while considering patient input and at the lowest cost. Planning and
implementation utilizes the assessment data to identify and execute actions (treatment plan)
that will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s
understanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their domestic
partner
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
ANSWER: 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
ANSWER: 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 apatient‘s ahaloperidol adosage awas areduced a2 aweeks aago ato adecrease aside aeffects.
aWhat aassessment aquestion ademonstrates athe anurse‘s aunderstanding aof athe aresulting
aneeds aof atheaclient?
a. ―Will ayou ahave aany adifficulty agetting a your aprescription arefilled?‖
b. ―Have a you abegun aexperiencing aany aforms aof ahallucinations?‖
c. ―What a do ayou aexpect awill aoccur asince athe adosage ahas abeen areduced?‖
d. ―What a can aI ado ato a help a you a manage athis areduction ain ahaloperidol
atherapy?‖
ANSWER: a B
It awill abe anecessary afor athe anurse ato aassess afor aexacerbation aof athe apatient‘s asymptoms
aof apsychosis aas awell aas afor aa alessening aof aside aeffects. aDosage adecrease amight alead ato
athe areturn aor aworsening aof apositive asymptoms asuch aas ahallucinations aand adelusions,
aand anegative asymptoms asuch aas ablunted aaffect, asocial awithdrawal, aand apoor agrooming.
aWhile athe aother aoptions amay abe aappropriate aassessment aquestions, athey aare anot adirected
aat athe acurrent aneeds aofathe aclient; athe aidentification aof aemerging apsychotic abehaviors.
DIF: Cognitive alevel: aAnalyzing TOP: a Nursing aprocess:
aAssessmentaMSC: a Client aNeeds: aPhysiologic aIntegrity
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
psychiatric setting. What is the nurse recruiter‘s best response?
a. ―The nurse primarily serves in a supportive role to members of the health care
delivery team.‖
b. ―The multidisciplinary approach eliminates the need to clearly define the
responsibilities of nursing in such a setting.‖
c. ―Nursing actions are identified by the institution that distinguishes nursing from
other mental health professions.‖
d. ―Nursing offers unique contributions to the psychotherapeutic management of
psychiatric patients.‖
ANSWER: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
application of psychotherapeutic management. Neither the facility nor the multidisciplinary
team define the professional responsibilities of its members but rather utilizes their unique
skills to provide holistic care. Ideally, all team members support each other and have
functions within the team.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Which component of the nursing process will the nurse focus upon to address the
responsibility to match individual patient needs with appropriate services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C
Proper assessment is critical for being able to determine the appropriate level of services that
will provide optimal care while considering patient input and at the lowest cost. Planning and
implementation utilizes the assessment data to identify and execute actions (treatment plan)
that will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s
understanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their domestic
partner
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
ANSWER: 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
ANSWER: 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 apatient‘s ahaloperidol adosage awas areduced a2 aweeks aago ato adecrease aside aeffects.
aWhat aassessment aquestion ademonstrates athe anurse‘s aunderstanding aof athe aresulting
aneeds aof atheaclient?
a. ―Will ayou ahave aany adifficulty agetting a your aprescription arefilled?‖
b. ―Have a you abegun aexperiencing aany aforms aof ahallucinations?‖
c. ―What a do ayou aexpect awill aoccur asince athe adosage ahas abeen areduced?‖
d. ―What a can aI ado ato a help a you a manage athis areduction ain ahaloperidol
atherapy?‖
ANSWER: a B
It awill abe anecessary afor athe anurse ato aassess afor aexacerbation aof athe apatient‘s asymptoms
aof apsychosis aas awell aas afor aa alessening aof aside aeffects. aDosage adecrease amight alead ato
athe areturn aor aworsening aof apositive asymptoms asuch aas ahallucinations aand adelusions,
aand anegative asymptoms asuch aas ablunted aaffect, asocial awithdrawal, aand apoor agrooming.
aWhile athe aother aoptions amay abe aappropriate aassessment aquestions, athey aare anot adirected
aat athe acurrent aneeds aofathe aclient; athe aidentification aof aemerging apsychotic abehaviors.
DIF: Cognitive alevel: aAnalyzing TOP: a Nursing aprocess:
aAssessmentaMSC: a Client aNeeds: aPhysiologic aIntegrity
