Psychiatric Nursing – 8th Edition (Norman L. Keltner & Debbie Steele) | Complete Test Bank with Questions, Answers, and Rationales

TEST BANK - Keltners Psychiatric Nursing, 9th
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Edition (Steele),
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Chapters 1 - 36 | All Chapters Complete
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,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8th Edition
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MULTIPLE CHOICE b




1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
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psychiatric setting. What is the nurse recruiter‘s best response?
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a. ―The nurse primarily serves in a supportive role to members of the health care
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delivery team.‖ b




b. ―The multidisciplinary approach eliminates the need to clearly define the
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responsibilities of nursing in such a setting.‖ b b b b b b




c. ―Nursing actions are identified by the institution that distinguishes nursing from
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other mental health professions.‖ b b b




d. ―Nursing offers unique contributions to the psychotherapeutic management of
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psychiatric patients.‖ b




ANSWER: D b




Professional role overlap cannot be denied; however, nursing is unique in its focus on and
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application of psychotherapeutic management. Neither the facility nor the multidisciplinaryteam
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define the professional responsibilities of its members but rather utilizes their unique skills to
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provide holistic care. Ideally, all team members support each other and have functions within the
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team.
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DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation b b b b b




MSC: Client Needs: Safe, Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to address the
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responsibility to match individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C b




Proper assessment is critical for being able to determine the appropriate level of services that will
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provide optimal care while considering patient input and at the lowest cost. Planning and
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implementation utilizes the assessment data to identify and execute actions (treatment plan) that
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will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying TOP: Nursing process: Assessment b b b b b




MSC: Client Needs: Safe, Effective Care Environment
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3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
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and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s
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understanding of effective psychotherapeutic management of this client?
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a. Discussing the disease process of schizophrenia with the client and their domestic b b b b b b b b b b b




partner
b. Minimizing contact between this patient and other patients to assure a stress free b b b b b b b b b b b b




milieu
c. Administering PRN medication when first observing the evidence that the client b b b b b b b b b b

, may be hallucinating b b




d. Independently determining that behavior modification is appropriate to decrease b b b b b b b b




the client‘s paranoid thoughts
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ANSWER: A b




An understanding of psychopathology is the foundation on which the three components of
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psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
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for understanding psychopharmacology and milieu management. Minimizing contact between the
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patient and others and administering PRN medication indiscriminately are nontherapeutic
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interventions. Using behavior modification to decrease the frequency of hallucinations would need
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to be incorporated into the plan of care by the care team.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation b b b b b




MSC: Client Needs: Safe, Effective Care Environment
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4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
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intervention is critical in assuring long-term, effective client care as described by
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psychotherapeutic management?
b b




a. Involvement in group therapies b b b




b. Focus of close supervision by the unit staff b b b b b b b




c. Maintaining effective communication with support system b b b b b




d. Frequently scheduled one-on-one time with nursing staff b b b b b b




ANSWER: D b




A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on-one time with nursing staff will help in establishing this b b b b b b b b b b b




connection. While the other options are appropriate and client centered, the nurse-client relation
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is critical in the long-term delivery of quality effective care to this client.
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DIF: Cognitive level: Applying TOP: Nursing process: Implementation b b b b b




MSC: Client Needs: Psychosocial Integrity
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5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
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assessment question demonstrates the nurse‘s understanding of the resulting needs of the
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client?
b




a. ―Will you have any difficulty getting your prescription refilled?‖
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b. ―Have you begun experiencing any forms of hallucinations?‖ b b b b b b b




c. ―What do you expect will occur since the dosage has been reduced?‖
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d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
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ANSWER: B b




It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
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as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
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positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
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affect, social withdrawal, and poor grooming. While the other options may be appropriate
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assessment questions, they are not directed at the current needs ofthe client; the identification of
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emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing b b TOP: Nursing process: Assessment b b b




MSC: Client Needs: Physiologic Integrity
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