Test Bank For Keltner’s Psychiatric Nursing, 9th Edition By Debbie
Steele | 9780323791960 | Chapter 1- 21 | Complete Guide New Edition
2025 Graded A+
, Psychiatric Nursing 8th Edition Keltner Test Bank
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/ 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.”
CORRECT::/ 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:/ Patient/ Needs:/ Safe,/ Effective/ Care/ Environment
N R I G B.C M
Ug pSroceNss/ wTill theOnurse/ focus/ upon/ to/ address/ the/
2. Which/ component/ of/the/ nursin
responsibility/ to/ match/ individual/ patient/ needs/ with/ appropriate/ services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
CORRECT::/ 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:/ Patient/ 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/ patient?
a. Discussing/ the/ disease/ process/ of/schizophrenia/ with/the/ patient/ 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/ patient
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, Psychiatric Nursing 8th Edition Keltner Test Bank
may/ be/ hallucinating
d. Independently/determining/ that/ behavior/ modification/ is/appropriate/to/ decrease/
the/ patient’s/ paranoid/ thoughts
CORRECT::/ 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:/ Patient/ 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/ patient/ 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
CORRECT::/ 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/ patient/ centered,/ the/ nurse-patient/
relation/ is/ critical/ in/ the/ lo ng N RSdeIliNveGrT
-/teUrm y/ oBf.qC
uaOliM
t y/ effective/ care/ to/ this/ patient.
DIF: Cognitive/ level:/ Applying TOP:/ Nursing/process:/
Implementation/ MSC:/ Patient/ 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/
patient?
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?”
CORRECT::/ 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/ patient;/ the/ identification/ of/ emerging/ psychotic/ behaviors.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/process:/
Assessment/ MSC:/ Patient/ Needs:/ Physiologic/ Integrity
NURSINGTB.COM
, Psychiatric Nursing 8th Edition Keltner Test Bank
6. Which/ statement/ forms/ the/ foundation/ upon/ which/ a/ nurse/ should/ base/ the/ implementation/ of/
psychotherapeutic/ management/ to/ the/ care/ of/ a/ patient/ with/ mental/ illness?
a. The/ nurse’s/ role/ in/ patient/ care/ is/ supported/ by/ the/ multidisciplinary/ team.
b. Omitting/ any/ one/ component/ will/ compromise/ the/ effectiveness/ of/ the/ treatment.
c. The/ most/ important/ element/ of/psychotherapeutic/ management/ is/ drug/ therapy.
d. A/therapeutic/ nurse-patient/ relationship/ is/ the/ most/ important/ aspect/ of/ treatment.
CORRECT::/ B
When/ one/ element/ is/ missing,/ treatment/ is/ usually/ compromised./ No/ single/ element/ is/ more/
important/ than/ the/ others;/ however,/ patients’/ needs/ govern/ the/ application/ of/the/ components/
and/ permit/ judicious/ use./ The/ remaining/ options/ identify/ components/ of/ the/
psychotherapeutic/ management/ process.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/process:/
Analysis/ MSC:/ Patient/ Needs:/ Safe,/ Effective/ Care/ Environment
7. Which/statement/ most/ accurately/ describes/ a/ nurse’s/ role/ regarding/ psychopharmacology?
a. “You/ will/ need/ to/ frequently/ make/ decisions/ regarding/ the/ administration/ of/PRN/
medications/ to/ help/ the/ patient/ manage/ anger.”
b. “It’s/ a/ nursing/ responsibility/ to/ adjust/ a/ medication/ dose/to/ assure/ effective/ patient/
responses.”
c. “Nurses/administers/ medications/ while/ evaluating/ drug/ effectiveness/ is/a/ medical/
responsibility.”
d. “To/ best/ assure/ appropriate/ response,/ a/ patient’s/ questions/ about/ drug/therapy/
should/ be/ referred/ to/ the/ psychiatrist.”
CORRECT::/ A
Nursing/ assessment/ and/ ana lN URoSf / dIata
ysis N Gmig
TBh.t/ sCuOg gMe s t / the/ need/ for/ PRN/ medication/ as/
patient/ anxiety/increases/ or/ psychotic/ symptoms/ become/ more/ acute./ The/ nurse/ is/ the/ health/
team/ member/ who/ makes/ this/ determination./ Nurses/ are/ responsible/ for/ monitoring/ drug
effectiveness/ as/ well/ as/ administering/ medication./ Nurses/ should/ assume/ responsibility/ for/
teaching/ patients/ about/ the/ side/ effects/ of/ medications./ Nurses/ cannot/ alter/ prescribed/ dosages/
of/ medications/ unless/ they/ have/ prescriptive/ privileges.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/process:/
Analysis/ MSC:/ Patient/ Needs:/ Safe,/ Effective/ Care/ Environment
8. When/considering/ environmental/aspects/ of/ milieu/ management,/ which/ intervention/ has/ the/
highest/ priority/ for/ a/ patient/ admitted/ after/ a/ failed/ suicide/ attempt?
a. Sending/ the/ patient’s/ new/ medication/ prescriptions/ to/ the/ pharmacy
b. Assigning/ a/ staff/ member/ to/ one-on-one/ observation/ of/ the/ patient
c. Orienting/ the/ patient/ to/ the/ milieu’s/ public/ and/ private/ spaces
d. Having/ all/ potentially/ dangerous/ items/ removed/ from/the/ patient’s/ belongings
CORRECT::/ B
Milieu/ management/ provides/ a/ proactive/ approach/ to/ care./ Safety/ overrides/ all/ other/
dimensions/ of/the/ milieu./ Initiation/ of/suicide/ precautions/ are/ the/ priority/ for/ this/ patient./ All/
the/ remaining/ options/ are/ appropriate/ but/ none/ protect/ the/ patient/ from/ the/ risk/ of/ another/
attempt/ to/ self-harm/ as/ effectively/ as/ one-on-one/ observation/ as/ part/ of/ suicide/ precautions.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/ process:/ Implementation
NURSINGTB.COM
Steele | 9780323791960 | Chapter 1- 21 | Complete Guide New Edition
2025 Graded A+
, Psychiatric Nursing 8th Edition Keltner Test Bank
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/ 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.”
CORRECT::/ 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:/ Patient/ Needs:/ Safe,/ Effective/ Care/ Environment
N R I G B.C M
Ug pSroceNss/ wTill theOnurse/ focus/ upon/ to/ address/ the/
2. Which/ component/ of/the/ nursin
responsibility/ to/ match/ individual/ patient/ needs/ with/ appropriate/ services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
CORRECT::/ 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:/ Patient/ 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/ patient?
a. Discussing/ the/ disease/ process/ of/schizophrenia/ with/the/ patient/ 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/ patient
NURSINGTB.COM
, Psychiatric Nursing 8th Edition Keltner Test Bank
may/ be/ hallucinating
d. Independently/determining/ that/ behavior/ modification/ is/appropriate/to/ decrease/
the/ patient’s/ paranoid/ thoughts
CORRECT::/ 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:/ Patient/ 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/ patient/ 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
CORRECT::/ 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/ patient/ centered,/ the/ nurse-patient/
relation/ is/ critical/ in/ the/ lo ng N RSdeIliNveGrT
-/teUrm y/ oBf.qC
uaOliM
t y/ effective/ care/ to/ this/ patient.
DIF: Cognitive/ level:/ Applying TOP:/ Nursing/process:/
Implementation/ MSC:/ Patient/ 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/
patient?
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?”
CORRECT::/ 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/ patient;/ the/ identification/ of/ emerging/ psychotic/ behaviors.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/process:/
Assessment/ MSC:/ Patient/ Needs:/ Physiologic/ Integrity
NURSINGTB.COM
, Psychiatric Nursing 8th Edition Keltner Test Bank
6. Which/ statement/ forms/ the/ foundation/ upon/ which/ a/ nurse/ should/ base/ the/ implementation/ of/
psychotherapeutic/ management/ to/ the/ care/ of/ a/ patient/ with/ mental/ illness?
a. The/ nurse’s/ role/ in/ patient/ care/ is/ supported/ by/ the/ multidisciplinary/ team.
b. Omitting/ any/ one/ component/ will/ compromise/ the/ effectiveness/ of/ the/ treatment.
c. The/ most/ important/ element/ of/psychotherapeutic/ management/ is/ drug/ therapy.
d. A/therapeutic/ nurse-patient/ relationship/ is/ the/ most/ important/ aspect/ of/ treatment.
CORRECT::/ B
When/ one/ element/ is/ missing,/ treatment/ is/ usually/ compromised./ No/ single/ element/ is/ more/
important/ than/ the/ others;/ however,/ patients’/ needs/ govern/ the/ application/ of/the/ components/
and/ permit/ judicious/ use./ The/ remaining/ options/ identify/ components/ of/ the/
psychotherapeutic/ management/ process.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/process:/
Analysis/ MSC:/ Patient/ Needs:/ Safe,/ Effective/ Care/ Environment
7. Which/statement/ most/ accurately/ describes/ a/ nurse’s/ role/ regarding/ psychopharmacology?
a. “You/ will/ need/ to/ frequently/ make/ decisions/ regarding/ the/ administration/ of/PRN/
medications/ to/ help/ the/ patient/ manage/ anger.”
b. “It’s/ a/ nursing/ responsibility/ to/ adjust/ a/ medication/ dose/to/ assure/ effective/ patient/
responses.”
c. “Nurses/administers/ medications/ while/ evaluating/ drug/ effectiveness/ is/a/ medical/
responsibility.”
d. “To/ best/ assure/ appropriate/ response,/ a/ patient’s/ questions/ about/ drug/therapy/
should/ be/ referred/ to/ the/ psychiatrist.”
CORRECT::/ A
Nursing/ assessment/ and/ ana lN URoSf / dIata
ysis N Gmig
TBh.t/ sCuOg gMe s t / the/ need/ for/ PRN/ medication/ as/
patient/ anxiety/increases/ or/ psychotic/ symptoms/ become/ more/ acute./ The/ nurse/ is/ the/ health/
team/ member/ who/ makes/ this/ determination./ Nurses/ are/ responsible/ for/ monitoring/ drug
effectiveness/ as/ well/ as/ administering/ medication./ Nurses/ should/ assume/ responsibility/ for/
teaching/ patients/ about/ the/ side/ effects/ of/ medications./ Nurses/ cannot/ alter/ prescribed/ dosages/
of/ medications/ unless/ they/ have/ prescriptive/ privileges.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/process:/
Analysis/ MSC:/ Patient/ Needs:/ Safe,/ Effective/ Care/ Environment
8. When/considering/ environmental/aspects/ of/ milieu/ management,/ which/ intervention/ has/ the/
highest/ priority/ for/ a/ patient/ admitted/ after/ a/ failed/ suicide/ attempt?
a. Sending/ the/ patient’s/ new/ medication/ prescriptions/ to/ the/ pharmacy
b. Assigning/ a/ staff/ member/ to/ one-on-one/ observation/ of/ the/ patient
c. Orienting/ the/ patient/ to/ the/ milieu’s/ public/ and/ private/ spaces
d. Having/ all/ potentially/ dangerous/ items/ removed/ from/the/ patient’s/ belongings
CORRECT::/ B
Milieu/ management/ provides/ a/ proactive/ approach/ to/ care./ Safety/ overrides/ all/ other/
dimensions/ of/the/ milieu./ Initiation/ of/suicide/ precautions/ are/ the/ priority/ for/ this/ patient./ All/
the/ remaining/ options/ are/ appropriate/ but/ none/ protect/ the/ patient/ from/ the/ risk/ of/ another/
attempt/ to/ self-harm/ as/ effectively/ as/ one-on-one/ observation/ as/ part/ of/ suicide/ precautions.
DIF: Cognitive/ level:/ Analyzing TOP:/ Nursing/ process:/ Implementation
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