, Psychiatric thNursing th8th thEdition thKeltner thTest
Bank
Chapter 01: Med, Meds, Milieu
th th th th
Keltner: Psychiatric Nursing, 8th Edition
th th th th
MULTIPLE thCHOICE
1. A thnewly thlicensed thasks tha thnursing threcruiter thfor tha thdescription thof thnursing thpractice
th in ththe thpsychiatric thsetting. thWhat this ththe thnurse threcruiter‟s thbest thresponse?
a. “The thnurse thprimarily thserves thin tha thsupportive throle thto thmembers thof ththe thhealth
th care thdelivery thteam.”
b. “The thmultidisciplinary thapproach theliminates ththe thneed thto thclearly thdefine
th the thresponsibilities thof thnursing thin thsuch tha thsetting.”
c. “Nursing thactions thare thidentified thby ththe thinstitution ththat thdistinguishes thnursing
th from thother thmental thhealth thprofessions.”
d. “Nursing thoffers thunique thcontributions thto ththe thpsychotherapeutic thmanagement
th of thpsychiatric thpatients.”
ANS: t h D
Professional throle thoverlap thcannot thbe thdenied; thhowever, thnursing this thunique thin thits thfocus thon
thand thapplication thof thpsychotherapeutic thmanagement. thNeither ththe thfacility thnor ththe
thmultidisciplinary thteam thdefine ththe thprofessional thresponsibilities thof thits thmembers thbut thrather
thutilizes ththeir thunique thskills thto thprovide thholistic thcare. thIdeally, thall thteam thmembers thsupport
theach thother thand thhave thfunctions thwithin ththe thteam.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thImplementation thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
2. Which thcomponent thof ththe thnursinUg pS
N R I G B.C M
roceNss thw
Till theOnurse thfocus thupon thto thaddress
ththe thresponsibility thto thmatch thindividual thpatient thneeds thwith thappropriate
thservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: t h C
Proper thassessment this thcritical thfor thbeing thable thto thdetermine ththe thappropriate thlevel thof thservices
ththat thwill thprovide thoptimal thcare thwhile thconsidering thpatient thinput thand that ththe thlowest thcost.
thPlanning thand thimplementation thutilizes ththe thassessment thdata thto thidentify thand thexecute thactions
th(treatment thplan) ththat thwill thprovide thappropriate thcare. thEvaluation thvalidates ththe theffectiveness
thof ththe thtreatment thplan.
DIF: Cognitive thlevel: thApplying TOP: t h Nursing thprocess:
thAssessment thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
3. An thadult thdiagnosed thwith thparanoid thschizophrenia thfrequent thexperiences thauditory
hallucinations thand thwalks thabout ththe thunit, thmuttering. thWhich thnursing thaction thdemonstrates
th
the thnurse‟s thunderstanding thof theffective thpsychotherapeutic thmanagement thof ththis thclient?
th
a. Discussing ththe thdisease thprocess thof thschizophrenia thwith ththe thclient thand ththeir
thdomestic thpartner
b. Minimizing thcontact thbetween ththis thpatient thand thother thpatients thto thassure tha thstress
thfree thmilieu
c. Administering thPRN thmedication thwhen thfirst thobserving ththe thevidence ththat ththe thclient
NURSINGTB.COM
, Psychiatric thNursing th8th thEdition thKeltner thTest
Bank
may thbe thhallucinating
d. Independently thdetermining ththat thbehavior thmodification this thappropriate thto
decrease ththe thclient‟s thparanoid ththoughts
th
ANS: t h A
An thunderstanding thof thpsychopathology this ththe thfoundation thon thwhich ththe ththree thcomponents
thof thpsychotherapeutic thmanagement threst; thit thfacilitates ththerapeutic thcommunication thand
thprovides tha thbasis thfor thunderstanding thpsychopharmacology thand thmilieu thmanagement.
thMinimizing thcontact thbetween ththe thpatient thand thothers thand thadministering thPRN thmedication
thindiscriminately thare thnontherapeutic thinterventions. thUsing thbehavior thmodification thto thdecrease
ththe thfrequency thof thhallucinations thwould thneed thto thbe thincorporated thinto ththe thplan thof thcare thby
ththe thcare thteam.
DIF: Cognitive thlevel: thApplying TOP: t h Nursing thprocess:
thImplementation thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
4. An thadult thdiagnosed thwith thchronic thdepression this thhospitalized thafter tha thsuicide thattempt.
Which thintervention this thcritical thin thassuring thlong-term, theffective thclient thcare thas
th
described thby thpsychotherapeutic thmanagement?
th
a. Involvement thin thgroup ththerapies
b. Focus thof thclose thsupervision thby ththe thunit thstaff
c. Maintaining theffective thcommunication thwith thsupport thsystem
d. Frequently thscheduled thone-on-one thtime thwith thnursing thstaff
ANS: t h D
A thcritical thelement thof thpsychotherapeutic thmanagement this ththe thpresence thof tha ththerapeutic
nurse-patient threlationship. thOne-on-one thtime thwith thnursing thstaff thwill thhelp thin thestablishing
ththis thconnection. thWhile ththe thother thoptions thare thappropriate thand thclient thcentered, ththe thnurse-
client threlation this thcritical thin ththe thl o n g N RSdeIliNveGrT
- teUrm y thB
of.qC
uaOliM
ty theffective thcare thto ththis thclient.
DIF: Cognitive thlevel: thApplying TOP: t h Nursing thprocess:
thImplementation thMSC: t h Client thNeeds: thPsychosocial thIntegrity
5. A thpatient‟s thhaloperidol thdosage thwas threduced th2 thweeks thago thto thdecrease thside theffects.
thWhat thassessment thquestion thdemonstrates ththe thnurse‟s thunderstanding thof ththe thresulting
thneeds thof ththe thclient?
a. “Will thyou thhave thany thdifficulty thgetting thyour thprescription threfilled?”
b. “Have thyou thbegun thexperiencing thany thforms thof thhallucinations?”
c. “What thdo thyou thexpect thwill thoccur thsince ththe thdosage thhas thbeen threduced?”
d. “What thcan thI thdo thto thhelp thyou thmanage ththis threduction thin thhaloperidol ththerapy?”
ANS: t h B
It thwill thbe thnecessary thfor ththe thnurse thto thassess thfor thexacerbation thof ththe thpatient‟s thsymptoms
thof thpsychosis thas thwell thas thfor tha thlessening thof thside theffects. thDosage thdecrease thmight thlead thto
ththe threturn thor thworsening thof thpositive thsymptoms thsuch thas thhallucinations thand thdelusions, thand
thnegative thsymptoms thsuch thas thblunted thaffect, thsocial thwithdrawal, thand thpoor thgrooming.
thWhile ththe thother thoptions thmay thbe thappropriate thassessment thquestions, ththey thare thnot thdirected
that ththe thcurrent thneeds thof ththe thclient; ththe thidentification thof themerging thpsychotic thbehaviors.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thAssessment thMSC: t h Client thNeeds: thPhysiologic thIntegrity
NURSINGTB.COM
, Psychiatric thNursing th8th thEdition thKeltner thTest
Bank
6. Which thstatement thforms ththe thfoundation thupon thwhich tha thnurse thshould thbase ththe
thimplementation thof thpsychotherapeutic thmanagement thto ththe thcare thof tha thpatient thwith thmental
thillness?
a. The thnurse‟s throle thin thclient thcare this thsupported thby ththe thmultidisciplinary thteam.
b. Omitting thany thone thcomponent thwill thcompromise ththe theffectiveness thof ththe thtreatment.
c. The thmost thimportant thelement thof thpsychotherapeutic thmanagement this thdrug ththerapy.
d. A ththerapeutic thnurse-patient threlationship this ththe thmost thimportant thaspect thof thtreatment.
ANS: t h B
When thone thelement this thmissing, thtreatment this thusually thcompromised. thNo thsingle thelement this
thmore thimportant ththan ththe thothers; thhowever, thpatients‟ thneeds thgovern ththe thapplication thof ththe
thcomponents thand thpermit thjudicious thuse. thThe thremaining thoptions thidentify thcomponents thof
ththe thpsychotherapeutic thmanagement thprocess.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thAnalysis thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
7. Which thstatement thmost thaccurately thdescribes tha thnurse‟s throle thregarding thpsychopharmacology?
a. “You thwill thneed thto thfrequently thmake thdecisions thregarding ththe thadministration thof
thPRN thmedications thto thhelp ththe thclient thmanage thanger.”
b. “It‟s tha thnursing thresponsibility thto thadjust tha thmedication thdose thto thassure theffective
th patient thresponses.”
c. “Nurses thadministers thmedications thwhile thevaluating thdrug theffectiveness this tha
medical thresponsibility.”
th
d. “To thbest thassure thappropriate thresponse, tha thpatient‟s thquestions thabout thdrug
ththerapy thshould thbe threferred thto ththe thpsychiatrist.”
ANS: t h A
Nursing thassessment thand thanalN isRoS
ysU f thdIaN
taGmTigBh.
t thsCuO
ggMest ththe thneed thfor thPRN thmedication thas
thpatient thanxiety thincreases thor thpsychotic thsymptoms thbecome thmore thacute. thThe thnurse this ththe
thhealth
team thmember thwho thmakes ththis thdetermination. thNurses thare thresponsible thfor thmonitoring thdrug
theffectiveness thas thwell thas thadministering thmedication. thNurses thshould thassume thresponsibility
thfor thteaching thpatients thabout ththe thside theffects thof thmedications. thNurses thcannot thalter thprescribed
thdosages thof thmedications thunless ththey thhave thprescriptive thprivileges.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thAnalysis thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
8. When thconsidering thenvironmental thaspects thof thmilieu thmanagement, thwhich thintervention thhas
the thhighest thpriority thfor tha thclient thadmitted thafter tha thfailed thsuicide thattempt?
th
a. Sending ththe thclient‟s thnew thmedication thprescriptions thto ththe thpharmacy
b. Assigning tha thstaff thmember thto thone-on-one thobservation thof ththe thclient
c. Orienting ththe thclient thto ththe thmilieu‟s thpublic thand thprivate thspaces
d. Having thall thpotentially thdangerous thitems thremoved thfrom ththe thclient‟s thbelongings
ANS: t h B
Milieu thmanagement thprovides tha thproactive thapproach thto thcare. thSafety thoverrides thall thother
thdimensions thof ththe thmilieu. thInitiation thof thsuicide thprecautions thare ththe thpriority thfor ththis thclient.
thAll ththe thremaining thoptions thare thappropriate thbut thnone thprotect ththe thclient thfrom ththe thrisk thof
thanother thattempt thto thself-harm thas theffectively thas thone-on-one thobservation thas thpart thof thsuicide
thprecautions.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess: thImplementation
NURSINGTB.COM
Bank
Chapter 01: Med, Meds, Milieu
th th th th
Keltner: Psychiatric Nursing, 8th Edition
th th th th
MULTIPLE thCHOICE
1. A thnewly thlicensed thasks tha thnursing threcruiter thfor tha thdescription thof thnursing thpractice
th in ththe thpsychiatric thsetting. thWhat this ththe thnurse threcruiter‟s thbest thresponse?
a. “The thnurse thprimarily thserves thin tha thsupportive throle thto thmembers thof ththe thhealth
th care thdelivery thteam.”
b. “The thmultidisciplinary thapproach theliminates ththe thneed thto thclearly thdefine
th the thresponsibilities thof thnursing thin thsuch tha thsetting.”
c. “Nursing thactions thare thidentified thby ththe thinstitution ththat thdistinguishes thnursing
th from thother thmental thhealth thprofessions.”
d. “Nursing thoffers thunique thcontributions thto ththe thpsychotherapeutic thmanagement
th of thpsychiatric thpatients.”
ANS: t h D
Professional throle thoverlap thcannot thbe thdenied; thhowever, thnursing this thunique thin thits thfocus thon
thand thapplication thof thpsychotherapeutic thmanagement. thNeither ththe thfacility thnor ththe
thmultidisciplinary thteam thdefine ththe thprofessional thresponsibilities thof thits thmembers thbut thrather
thutilizes ththeir thunique thskills thto thprovide thholistic thcare. thIdeally, thall thteam thmembers thsupport
theach thother thand thhave thfunctions thwithin ththe thteam.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thImplementation thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
2. Which thcomponent thof ththe thnursinUg pS
N R I G B.C M
roceNss thw
Till theOnurse thfocus thupon thto thaddress
ththe thresponsibility thto thmatch thindividual thpatient thneeds thwith thappropriate
thservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: t h C
Proper thassessment this thcritical thfor thbeing thable thto thdetermine ththe thappropriate thlevel thof thservices
ththat thwill thprovide thoptimal thcare thwhile thconsidering thpatient thinput thand that ththe thlowest thcost.
thPlanning thand thimplementation thutilizes ththe thassessment thdata thto thidentify thand thexecute thactions
th(treatment thplan) ththat thwill thprovide thappropriate thcare. thEvaluation thvalidates ththe theffectiveness
thof ththe thtreatment thplan.
DIF: Cognitive thlevel: thApplying TOP: t h Nursing thprocess:
thAssessment thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
3. An thadult thdiagnosed thwith thparanoid thschizophrenia thfrequent thexperiences thauditory
hallucinations thand thwalks thabout ththe thunit, thmuttering. thWhich thnursing thaction thdemonstrates
th
the thnurse‟s thunderstanding thof theffective thpsychotherapeutic thmanagement thof ththis thclient?
th
a. Discussing ththe thdisease thprocess thof thschizophrenia thwith ththe thclient thand ththeir
thdomestic thpartner
b. Minimizing thcontact thbetween ththis thpatient thand thother thpatients thto thassure tha thstress
thfree thmilieu
c. Administering thPRN thmedication thwhen thfirst thobserving ththe thevidence ththat ththe thclient
NURSINGTB.COM
, Psychiatric thNursing th8th thEdition thKeltner thTest
Bank
may thbe thhallucinating
d. Independently thdetermining ththat thbehavior thmodification this thappropriate thto
decrease ththe thclient‟s thparanoid ththoughts
th
ANS: t h A
An thunderstanding thof thpsychopathology this ththe thfoundation thon thwhich ththe ththree thcomponents
thof thpsychotherapeutic thmanagement threst; thit thfacilitates ththerapeutic thcommunication thand
thprovides tha thbasis thfor thunderstanding thpsychopharmacology thand thmilieu thmanagement.
thMinimizing thcontact thbetween ththe thpatient thand thothers thand thadministering thPRN thmedication
thindiscriminately thare thnontherapeutic thinterventions. thUsing thbehavior thmodification thto thdecrease
ththe thfrequency thof thhallucinations thwould thneed thto thbe thincorporated thinto ththe thplan thof thcare thby
ththe thcare thteam.
DIF: Cognitive thlevel: thApplying TOP: t h Nursing thprocess:
thImplementation thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
4. An thadult thdiagnosed thwith thchronic thdepression this thhospitalized thafter tha thsuicide thattempt.
Which thintervention this thcritical thin thassuring thlong-term, theffective thclient thcare thas
th
described thby thpsychotherapeutic thmanagement?
th
a. Involvement thin thgroup ththerapies
b. Focus thof thclose thsupervision thby ththe thunit thstaff
c. Maintaining theffective thcommunication thwith thsupport thsystem
d. Frequently thscheduled thone-on-one thtime thwith thnursing thstaff
ANS: t h D
A thcritical thelement thof thpsychotherapeutic thmanagement this ththe thpresence thof tha ththerapeutic
nurse-patient threlationship. thOne-on-one thtime thwith thnursing thstaff thwill thhelp thin thestablishing
ththis thconnection. thWhile ththe thother thoptions thare thappropriate thand thclient thcentered, ththe thnurse-
client threlation this thcritical thin ththe thl o n g N RSdeIliNveGrT
- teUrm y thB
of.qC
uaOliM
ty theffective thcare thto ththis thclient.
DIF: Cognitive thlevel: thApplying TOP: t h Nursing thprocess:
thImplementation thMSC: t h Client thNeeds: thPsychosocial thIntegrity
5. A thpatient‟s thhaloperidol thdosage thwas threduced th2 thweeks thago thto thdecrease thside theffects.
thWhat thassessment thquestion thdemonstrates ththe thnurse‟s thunderstanding thof ththe thresulting
thneeds thof ththe thclient?
a. “Will thyou thhave thany thdifficulty thgetting thyour thprescription threfilled?”
b. “Have thyou thbegun thexperiencing thany thforms thof thhallucinations?”
c. “What thdo thyou thexpect thwill thoccur thsince ththe thdosage thhas thbeen threduced?”
d. “What thcan thI thdo thto thhelp thyou thmanage ththis threduction thin thhaloperidol ththerapy?”
ANS: t h B
It thwill thbe thnecessary thfor ththe thnurse thto thassess thfor thexacerbation thof ththe thpatient‟s thsymptoms
thof thpsychosis thas thwell thas thfor tha thlessening thof thside theffects. thDosage thdecrease thmight thlead thto
ththe threturn thor thworsening thof thpositive thsymptoms thsuch thas thhallucinations thand thdelusions, thand
thnegative thsymptoms thsuch thas thblunted thaffect, thsocial thwithdrawal, thand thpoor thgrooming.
thWhile ththe thother thoptions thmay thbe thappropriate thassessment thquestions, ththey thare thnot thdirected
that ththe thcurrent thneeds thof ththe thclient; ththe thidentification thof themerging thpsychotic thbehaviors.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thAssessment thMSC: t h Client thNeeds: thPhysiologic thIntegrity
NURSINGTB.COM
, Psychiatric thNursing th8th thEdition thKeltner thTest
Bank
6. Which thstatement thforms ththe thfoundation thupon thwhich tha thnurse thshould thbase ththe
thimplementation thof thpsychotherapeutic thmanagement thto ththe thcare thof tha thpatient thwith thmental
thillness?
a. The thnurse‟s throle thin thclient thcare this thsupported thby ththe thmultidisciplinary thteam.
b. Omitting thany thone thcomponent thwill thcompromise ththe theffectiveness thof ththe thtreatment.
c. The thmost thimportant thelement thof thpsychotherapeutic thmanagement this thdrug ththerapy.
d. A ththerapeutic thnurse-patient threlationship this ththe thmost thimportant thaspect thof thtreatment.
ANS: t h B
When thone thelement this thmissing, thtreatment this thusually thcompromised. thNo thsingle thelement this
thmore thimportant ththan ththe thothers; thhowever, thpatients‟ thneeds thgovern ththe thapplication thof ththe
thcomponents thand thpermit thjudicious thuse. thThe thremaining thoptions thidentify thcomponents thof
ththe thpsychotherapeutic thmanagement thprocess.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thAnalysis thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
7. Which thstatement thmost thaccurately thdescribes tha thnurse‟s throle thregarding thpsychopharmacology?
a. “You thwill thneed thto thfrequently thmake thdecisions thregarding ththe thadministration thof
thPRN thmedications thto thhelp ththe thclient thmanage thanger.”
b. “It‟s tha thnursing thresponsibility thto thadjust tha thmedication thdose thto thassure theffective
th patient thresponses.”
c. “Nurses thadministers thmedications thwhile thevaluating thdrug theffectiveness this tha
medical thresponsibility.”
th
d. “To thbest thassure thappropriate thresponse, tha thpatient‟s thquestions thabout thdrug
ththerapy thshould thbe threferred thto ththe thpsychiatrist.”
ANS: t h A
Nursing thassessment thand thanalN isRoS
ysU f thdIaN
taGmTigBh.
t thsCuO
ggMest ththe thneed thfor thPRN thmedication thas
thpatient thanxiety thincreases thor thpsychotic thsymptoms thbecome thmore thacute. thThe thnurse this ththe
thhealth
team thmember thwho thmakes ththis thdetermination. thNurses thare thresponsible thfor thmonitoring thdrug
theffectiveness thas thwell thas thadministering thmedication. thNurses thshould thassume thresponsibility
thfor thteaching thpatients thabout ththe thside theffects thof thmedications. thNurses thcannot thalter thprescribed
thdosages thof thmedications thunless ththey thhave thprescriptive thprivileges.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess:
thAnalysis thMSC: t h Client thNeeds: thSafe, thEffective thCare thEnvironment
8. When thconsidering thenvironmental thaspects thof thmilieu thmanagement, thwhich thintervention thhas
the thhighest thpriority thfor tha thclient thadmitted thafter tha thfailed thsuicide thattempt?
th
a. Sending ththe thclient‟s thnew thmedication thprescriptions thto ththe thpharmacy
b. Assigning tha thstaff thmember thto thone-on-one thobservation thof ththe thclient
c. Orienting ththe thclient thto ththe thmilieu‟s thpublic thand thprivate thspaces
d. Having thall thpotentially thdangerous thitems thremoved thfrom ththe thclient‟s thbelongings
ANS: t h B
Milieu thmanagement thprovides tha thproactive thapproach thto thcare. thSafety thoverrides thall thother
thdimensions thof ththe thmilieu. thInitiation thof thsuicide thprecautions thare ththe thpriority thfor ththis thclient.
thAll ththe thremaining thoptions thare thappropriate thbut thnone thprotect ththe thclient thfrom ththe thrisk thof
thanother thattempt thto thself-harm thas theffectively thas thone-on-one thobservation thas thpart thof thsuicide
thprecautions.
DIF: Cognitive thlevel: thAnalyzing TOP: t h Nursing thprocess: thImplementation
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