FULL TEST BANK
TEST BANK FOR KELTNER’S PSYCHIATRIC
NURSING 9TH EDITION BY DEBBIE STEELE
PRINTED PDF | ORIGINAL DIRECTLY FROM THE PUBLISHER | 100%
VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
Complete Test bank, All Chapters are included.
For more Test banks, ATI, HESI exams, and more contact us.
,Table of content
Chapter 1. Me, Meds, Milieu
Chapter 2. Historical Issues
Chapter 3. Legal Issues
Chapter 4. Psychobiologic Bases of Behavior
Chapter 5. Cultural Issues
Chapter 6. Spirituality Issues
Chapter 7. Models for Working With Psychiatric Patients
Chapter 8. Learning to Communicate Professionally
Chapter 9. Working With an Individual Patient
Chapter 10. Working With Groups of Patients
Chapter 11. Working With the Family
Chapter 12. Introduction to Psychotropic Drugs
Chapter 13. Antiparkinsonian Drugs
Chapter 14. Antipsychotic Drugs
Chapter 15. Antidepressant Drugs
Chapter 16. Antimanic Drugs
Chapter 17. Antianxiety Drugs
Chapter 18. Antidementia Drugs
Chapter 19. Alternative Preparations and Over-the-Counter Drugs
Chapter 20. Introduction to Milieu Management
Chapter 21. Variables Affecting the Therapeutic Environment: Violence and
Suicide
Chapter 22. Therapeutic Environment in Various Treatment Settings
Chapter 23. Introduction to Psychopathology
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders
Chapter 25. Depressive Disorders
Chapter 26. Bipolar Disorders
Chapter 27. Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-
Related, Somatic, and Dissociative Disorders
Chapter 28. Neurocognitive Disorders
Chapter 29. Personality Disorders
Chapter 30. Sexual Disorders and Gender Dysphoria
Chapter 31. Substance Use Disorders
Chapter 32. Eating Disorders
Chapter 33. Survivors of Violence and Trauma
Chapter 34. Children and Adolescents
,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.‖
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
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. Implementation
ANSWER: 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: 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
ANSWER: 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
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 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?‖
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 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
,6. Which Statement Forms The Foundation Upon Which A Nurse Should Base The
Implementationof Psychotherapeutic Management To The Care Of A Patient With Mental
Illness?
A. The Nurse‘S Role In Client 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.
ANSWER: 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: Client 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 Client 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.‖
ANSWER: A
Nursing Assessment And Analysis Of Data Might Suggest 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: Client Needs: Safe, Effective Care Environment
8. When Considering Environmental Aspects Of Milieu Management, Which Intervention
Has The Highest Priority For A Client Admitted After A Failed Suicide Attempt?
A. Sending The Client‘S New Medication Prescriptions To The Pharmacy
B. Assigning A Staff Member To One-On-One Observation Of The Client
C. Orienting The Client To The Milieu‘S Public And Private Spaces
D. Having All Potentially Dangerous Items Removed From The Client‘S
Belongings
ANSWER: 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
Client. All The Remaining Options Are Appropriate But None Protect The Client 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
, MSC: Client Needs: Safe, Effective Care Environment
9. The Implementation Of Which Unit Policy Directed At Milieu Balance Would Reflect A
Need For Reconsideration On The Part Of The Treatment Team?
A. All Clients Will Receive Verbal And Written Information Explaining Unit
Rules.
B. Unit Clients Will Engage In All Unit Activities To Assure Interaction With
Both Staff And Other Clients.
C. All Clients Will Be Uniformly Expected To Present Themselves In A
Nonviolent
Manner To Both Staff And Other Clients.
D. At Times Of Unit Stress, Client Will Return To Their Rooms.
ANSWER: B
The Situation Described Suggests A Milieu In Which Patients Have No Time For Planned
Therapeutic Encounters With Staff; Hence, It Is A Milieu Lacking Balance. The Remaining
Options Address Unit Norms, Limit Setting, And Environmental Modifications That Are
Reasonable And Will Contribute To A Therapeutic Milieu.
DIF: Cognitive Level: Evaluating TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
10. Which Intervention Should The Nurse Implement When Focusing
Oncommunicating Therapeutically With A Client?
A. Explaining To The Client Why They Will Need To Ask For A Razor
B. Providing The Client With Options To Help Achieve Smoking Cessation
C. Encouraging The Client To Identify Personal Stressors
D. Assuring The Client That They Can Receive Telephone Call On The Unit
Telephone
ANSWER: C
A Nurse Uses Therapeutic Communication Techniques As Part Of The Therapeutic Nurse-
Patient Relationship. An Example Of Such Communication Is Providing The Client With An
Opportunity To Safely Identify Personal Stressors. The Remaining Options Address Safety,
Balance, And Norms Associated With Their Care.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
11. During The Risk Assessment Phase Of Care For A Psychiatric Patient, What Is The Nurse‘S
Primary Goal?
A. Making An Initial Assessment
B. Confirming The Patient‘S Problem
C. Assessing Potential Dangerousness To Self Or Others
D. Determining The Level Of Supervision Needed For The
Patient
ANSWER: C
Risk Assessment Involves Looking At Dangerousness To Self Or Others, The Degree Of
Disability, And Whether Or Not The Individual Is Acutely Psychotic To Determine The
Feasibility Of Community-Based Care Versus Hospital-Based Care. Risk Assessment
Usually Follows The Initial Assessment. Confirmation Of The Patient‘S Problem Is Not Part
Of The Risk Assessment Protocol. Arranging Entry Into The Mental Health System Will
Follow Risk Assessment If The Patient Is Assessed As Needing Service.
DIF: Cognitive Level: Applying TOP: Nursing Process: Assessment
, MSC: Client Needs: Safe, Effective Care Environment
12. Risk Assessment For A Patient Shows These Findings: Schizophrenia But Not Currently;
Not A Danger To Self Or Others; Lives In Parents‘ Home. Which Decision Regarding
Placement On The Continuum Of Care Is Appropriate?
A. Hospitalize The Patient.
B. Discharge The Patient From The System.
C. Refer The Patient To Outpatient Services.
D. Refer The Patient To Self-Help Resources In The
Community.
ANSWER: C
Referral Should Be Made To The Least Restrictive, Most Effective, And Most Cost-
Conscious Source Of Services. Because The Patient Is Not A Danger To Self Or Others,
Hospitalization Is Not Needed. However, Follow-Up As An Outpatient Would Be More
Appropriate Than Referral To A Self-Help Group, In Which Structure Might Be Lacking,
Or Discharge From The System.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
MSC: Client Needs: Safe, Effective Care Environment
13. A Patient Tells The Nurse, ―This Medicine Makes Me Feel Weird. I Don‘T Think I Should
Take It Anymore. Do You?‖ The Most Effective Reply That The Nurse Could Make Is
Based On Which Psychotherapeutic Management Model?
A. Psychopathology
B. Milieu Management
C. Psychopharmacology
D. Therapeutic Nurse-Patient
Relationship
ANSWER: C
Concerns About Medication Voiced By Patients Require The Nurse To Have Knowledge
About Psychotherapeutic Drugs To Make Helpful Responses. The Nurse-Patient Relationship
Component Is Based On Use Of Self. Milieu Management Is Concerned With The
Environment Of Care.
Psychopathology Provides Foundational Knowledge Of Mental Disorders But Would Be Less
Relevant In Framing A Response To The Patient Than Knowledge Of Psychopharmacology.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity
14. A Patient Tells The Nurse, ―This Medication Makes Me Feel Weird. I Don‘T Think I Should
Take It Anymore. Do You?‖ What Is The Nurse‘S Best Response?
A. ―I Wonder Why You Think That.‖
B. ―Tell Me How The Medication Makes You Feel.‖
C. ―One Must Never Stop Taking Medication.‖
D. ―You Need To Discuss This With Your
Psychiatrist.‖
ANSWER: B
As Part Of The Psychopharmacology Component Of Psychotherapeutic Management, The
Responsibility Of The Nurse Is To Gather Data About Patients‘ Responses To Medication
And To Be Alert For Side And Adverse Effects Of The Medication. The Other Responses
Are Tangential To The Real Issue.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
, MSC: Client Needs: Physiologic Integrity
TEST BANK FOR KELTNER’S PSYCHIATRIC
NURSING 9TH EDITION BY DEBBIE STEELE
PRINTED PDF | ORIGINAL DIRECTLY FROM THE PUBLISHER | 100%
VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
Complete Test bank, All Chapters are included.
For more Test banks, ATI, HESI exams, and more contact us.
,Table of content
Chapter 1. Me, Meds, Milieu
Chapter 2. Historical Issues
Chapter 3. Legal Issues
Chapter 4. Psychobiologic Bases of Behavior
Chapter 5. Cultural Issues
Chapter 6. Spirituality Issues
Chapter 7. Models for Working With Psychiatric Patients
Chapter 8. Learning to Communicate Professionally
Chapter 9. Working With an Individual Patient
Chapter 10. Working With Groups of Patients
Chapter 11. Working With the Family
Chapter 12. Introduction to Psychotropic Drugs
Chapter 13. Antiparkinsonian Drugs
Chapter 14. Antipsychotic Drugs
Chapter 15. Antidepressant Drugs
Chapter 16. Antimanic Drugs
Chapter 17. Antianxiety Drugs
Chapter 18. Antidementia Drugs
Chapter 19. Alternative Preparations and Over-the-Counter Drugs
Chapter 20. Introduction to Milieu Management
Chapter 21. Variables Affecting the Therapeutic Environment: Violence and
Suicide
Chapter 22. Therapeutic Environment in Various Treatment Settings
Chapter 23. Introduction to Psychopathology
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders
Chapter 25. Depressive Disorders
Chapter 26. Bipolar Disorders
Chapter 27. Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-
Related, Somatic, and Dissociative Disorders
Chapter 28. Neurocognitive Disorders
Chapter 29. Personality Disorders
Chapter 30. Sexual Disorders and Gender Dysphoria
Chapter 31. Substance Use Disorders
Chapter 32. Eating Disorders
Chapter 33. Survivors of Violence and Trauma
Chapter 34. Children and Adolescents
,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.‖
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
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. Implementation
ANSWER: 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: 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
ANSWER: 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
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 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?‖
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 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
,6. Which Statement Forms The Foundation Upon Which A Nurse Should Base The
Implementationof Psychotherapeutic Management To The Care Of A Patient With Mental
Illness?
A. The Nurse‘S Role In Client 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.
ANSWER: 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: Client 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 Client 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.‖
ANSWER: A
Nursing Assessment And Analysis Of Data Might Suggest 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: Client Needs: Safe, Effective Care Environment
8. When Considering Environmental Aspects Of Milieu Management, Which Intervention
Has The Highest Priority For A Client Admitted After A Failed Suicide Attempt?
A. Sending The Client‘S New Medication Prescriptions To The Pharmacy
B. Assigning A Staff Member To One-On-One Observation Of The Client
C. Orienting The Client To The Milieu‘S Public And Private Spaces
D. Having All Potentially Dangerous Items Removed From The Client‘S
Belongings
ANSWER: 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
Client. All The Remaining Options Are Appropriate But None Protect The Client 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
, MSC: Client Needs: Safe, Effective Care Environment
9. The Implementation Of Which Unit Policy Directed At Milieu Balance Would Reflect A
Need For Reconsideration On The Part Of The Treatment Team?
A. All Clients Will Receive Verbal And Written Information Explaining Unit
Rules.
B. Unit Clients Will Engage In All Unit Activities To Assure Interaction With
Both Staff And Other Clients.
C. All Clients Will Be Uniformly Expected To Present Themselves In A
Nonviolent
Manner To Both Staff And Other Clients.
D. At Times Of Unit Stress, Client Will Return To Their Rooms.
ANSWER: B
The Situation Described Suggests A Milieu In Which Patients Have No Time For Planned
Therapeutic Encounters With Staff; Hence, It Is A Milieu Lacking Balance. The Remaining
Options Address Unit Norms, Limit Setting, And Environmental Modifications That Are
Reasonable And Will Contribute To A Therapeutic Milieu.
DIF: Cognitive Level: Evaluating TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe, Effective Care Environment
10. Which Intervention Should The Nurse Implement When Focusing
Oncommunicating Therapeutically With A Client?
A. Explaining To The Client Why They Will Need To Ask For A Razor
B. Providing The Client With Options To Help Achieve Smoking Cessation
C. Encouraging The Client To Identify Personal Stressors
D. Assuring The Client That They Can Receive Telephone Call On The Unit
Telephone
ANSWER: C
A Nurse Uses Therapeutic Communication Techniques As Part Of The Therapeutic Nurse-
Patient Relationship. An Example Of Such Communication Is Providing The Client With An
Opportunity To Safely Identify Personal Stressors. The Remaining Options Address Safety,
Balance, And Norms Associated With Their Care.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
11. During The Risk Assessment Phase Of Care For A Psychiatric Patient, What Is The Nurse‘S
Primary Goal?
A. Making An Initial Assessment
B. Confirming The Patient‘S Problem
C. Assessing Potential Dangerousness To Self Or Others
D. Determining The Level Of Supervision Needed For The
Patient
ANSWER: C
Risk Assessment Involves Looking At Dangerousness To Self Or Others, The Degree Of
Disability, And Whether Or Not The Individual Is Acutely Psychotic To Determine The
Feasibility Of Community-Based Care Versus Hospital-Based Care. Risk Assessment
Usually Follows The Initial Assessment. Confirmation Of The Patient‘S Problem Is Not Part
Of The Risk Assessment Protocol. Arranging Entry Into The Mental Health System Will
Follow Risk Assessment If The Patient Is Assessed As Needing Service.
DIF: Cognitive Level: Applying TOP: Nursing Process: Assessment
, MSC: Client Needs: Safe, Effective Care Environment
12. Risk Assessment For A Patient Shows These Findings: Schizophrenia But Not Currently;
Not A Danger To Self Or Others; Lives In Parents‘ Home. Which Decision Regarding
Placement On The Continuum Of Care Is Appropriate?
A. Hospitalize The Patient.
B. Discharge The Patient From The System.
C. Refer The Patient To Outpatient Services.
D. Refer The Patient To Self-Help Resources In The
Community.
ANSWER: C
Referral Should Be Made To The Least Restrictive, Most Effective, And Most Cost-
Conscious Source Of Services. Because The Patient Is Not A Danger To Self Or Others,
Hospitalization Is Not Needed. However, Follow-Up As An Outpatient Would Be More
Appropriate Than Referral To A Self-Help Group, In Which Structure Might Be Lacking,
Or Discharge From The System.
DIF: Cognitive Level: Applying TOP: Nursing Process: Planning
MSC: Client Needs: Safe, Effective Care Environment
13. A Patient Tells The Nurse, ―This Medicine Makes Me Feel Weird. I Don‘T Think I Should
Take It Anymore. Do You?‖ The Most Effective Reply That The Nurse Could Make Is
Based On Which Psychotherapeutic Management Model?
A. Psychopathology
B. Milieu Management
C. Psychopharmacology
D. Therapeutic Nurse-Patient
Relationship
ANSWER: C
Concerns About Medication Voiced By Patients Require The Nurse To Have Knowledge
About Psychotherapeutic Drugs To Make Helpful Responses. The Nurse-Patient Relationship
Component Is Based On Use Of Self. Milieu Management Is Concerned With The
Environment Of Care.
Psychopathology Provides Foundational Knowledge Of Mental Disorders But Would Be Less
Relevant In Framing A Response To The Patient Than Knowledge Of Psychopharmacology.
DIF: Cognitive Level: Analyzing TOP: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity
14. A Patient Tells The Nurse, ―This Medication Makes Me Feel Weird. I Don‘T Think I Should
Take It Anymore. Do You?‖ What Is The Nurse‘S Best Response?
A. ―I Wonder Why You Think That.‖
B. ―Tell Me How The Medication Makes You Feel.‖
C. ―One Must Never Stop Taking Medication.‖
D. ―You Need To Discuss This With Your
Psychiatrist.‖
ANSWER: B
As Part Of The Psychopharmacology Component Of Psychotherapeutic Management, The
Responsibility Of The Nurse Is To Gather Data About Patients‘ Responses To Medication
And To Be Alert For Side And Adverse Effects Of The Medication. The Other Responses
Are Tangential To The Real Issue.
DIF: Cognitive Level: Applying TOP: Nursing Process: Implementation
, MSC: Client Needs: Physiologic Integrity
