TEST BANK - Keltners Psychiatric Nursing,
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed asks a nursing recruiter for a description of nursing practice in
thepsychiatric 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 fro
m
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 multidisciplinar
yteam define the professional responsibilities of its members but rather utilizes their uniq
ue skills to provide holistic care. Ideally, all team members support each other and have f
unctions within the team.
DIF: Cognitive level: Analyzing
TOP: Nursing process: Implementation MSC: Client Needs: Safe, Effecti
ve Care Environment
2. Which component of the nursing process will the nurse focus upon to address
theresponsibility 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 t
hat will provide optimal care while considering patient input and at the lowest cost. Planni
ng and implementation utilizes the assessment data to identify and execute actions (treatm
ent plan) that will provide appropriate care. Evaluation validates the effectiveness of the tre
atment plan.
DIF: Cognitive level: Applying
TOP: Nursing process: Assessment MSC: Client Needs: Safe, Effecti
ve Care Environment
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinatio
nsand walks about the unit, muttering. Which nursing action demonstrates the nurse‘s un
derstanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their domesti
c
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 p
sychotherapeutic management rest; it facilitates therapeutic communication and provides aba
sis for understanding psychopharmacology and milieu management. Minimizing contact bet
ween the patient and others and administering PRN medication indiscriminately are nonther
apeutic interventions. Using behavior modification to decrease the frequency of hallucinatio
ns 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, Effecti
ve Care Environment
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Wh
ich 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 optio
ns 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. W
hat 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?
‖
ANSWER: 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 ret
urn 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 nee
ds ofthe client; the identification of emerging psychotic behaviors.
DIF: Cognitive level: Analyzing
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed asks a nursing recruiter for a description of nursing practice in
thepsychiatric 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 fro
m
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 multidisciplinar
yteam define the professional responsibilities of its members but rather utilizes their uniq
ue skills to provide holistic care. Ideally, all team members support each other and have f
unctions within the team.
DIF: Cognitive level: Analyzing
TOP: Nursing process: Implementation MSC: Client Needs: Safe, Effecti
ve Care Environment
2. Which component of the nursing process will the nurse focus upon to address
theresponsibility 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 t
hat will provide optimal care while considering patient input and at the lowest cost. Planni
ng and implementation utilizes the assessment data to identify and execute actions (treatm
ent plan) that will provide appropriate care. Evaluation validates the effectiveness of the tre
atment plan.
DIF: Cognitive level: Applying
TOP: Nursing process: Assessment MSC: Client Needs: Safe, Effecti
ve Care Environment
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinatio
nsand walks about the unit, muttering. Which nursing action demonstrates the nurse‘s un
derstanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their domesti
c
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 p
sychotherapeutic management rest; it facilitates therapeutic communication and provides aba
sis for understanding psychopharmacology and milieu management. Minimizing contact bet
ween the patient and others and administering PRN medication indiscriminately are nonther
apeutic interventions. Using behavior modification to decrease the frequency of hallucinatio
ns 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, Effecti
ve Care Environment
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Wh
ich 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 optio
ns 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. W
hat 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?
‖
ANSWER: 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 ret
urn 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 nee
ds ofthe client; the identification of emerging psychotic behaviors.
DIF: Cognitive level: Analyzing
