TEST BANK
FOR
PSYCHIATRIC NURSING BY KELTNER & STEELE, 9TH EDITION | ALL
CHAPTERS INCLUDED (CH. 1-36)
GRADED A+
MBOFFIN
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Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed nurse 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.‖
ANS : 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. Implementa
tion
ANS : 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
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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 frequently
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
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
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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 which is the identification of
emerging psychotic behaviors.
DIF: Cognitive level: Analyzing TOP: Nursing process:
Assessment MSC: Client Needs: Physiologic Integrity
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