Test Bank for Keltner’s Psychiatric Nursing, 9th Edition by Debbie Steele |Chapter 1-36 | All Chapters , 100% VERIFIED A+

TEST BANK - Keltners Psychiatric Nursing, 9th
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Edition (Steele),
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Chapters 1 - 36 | All Chapters Complete
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,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8th Edition
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MULTIPLE CHOICE q




1. A newly licensed asks a nursing recruiter for a description of nursing practice in
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thepsychiatric setting. What is the nurse recruiter‘s best response?
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a. ―The nurse primarily serves in a supportive role to members of the health care
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delivery team.‖ q


b. ―The multidisciplinary approach eliminates the need to clearly define the
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responsibilities of nursing in such a setting.‖ q q q q q q


c. ―Nursing actions are identified by the institution that distinguishes nursing from
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other mental health professions.‖q q q


d. ―Nursing offers unique contributions to the psychotherapeutic management of
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psychiatric patients.‖ q




ANSWER: D q


Professional role overlap cannot be denied; however, nursing is unique in its focus on and
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application of psychotherapeutic management. Neither the facility nor the
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multidisciplinaryteam define the professional responsibilities of its members but rather
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utilizes their unique skills to provide holistic care. Ideally, all team members support each
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other and have functions within the team.
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DIF: Cognitive level: Analyzing TOP: Nursing process: q q q q


ImplementationMSC: Client Needs: Safe, Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to address
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theresponsibility to match individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C q


Proper assessment is critical for being able to determine the appropriate level of services that
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will provide optimal care while considering patient input and at the lowest cost. Planning and
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implementation utilizes the assessment data to identify and execute actions (treatment plan)
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that will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying TOP: Nursing process: q q q q


AssessmentMSC: Client Needs: Safe, Effective Care Environment
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3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory
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hallucinationsand walks about the unit, muttering. Which nursing action demonstrates the
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nurse‘s understanding of effective psychotherapeutic management of this client?
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a. Discussing the disease process of schizophrenia with the client and their domestic
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partner
b. Minimizing contact between this patient and other patients to assure a stress free
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milieu
c. Administering PRN medication when first observing the evidence that the client q q q q q q q q q q

, may be hallucinatingq q


d. Independently determining that behavior modification is appropriate to decrease q q q q q q q q


the client‘s paranoid thoughts
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ANSWER: A q


An understanding of psychopathology is the foundation on which the three components of
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psychotherapeutic management rest; it facilitates therapeutic communication and provides
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abasis for understanding psychopharmacology and milieu management. Minimizing contact
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between the patient and others and administering PRN medication indiscriminately are
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nontherapeutic interventions. Using behavior modification to decrease the frequency of
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hallucinations would need to be incorporated into the plan of care by the care team.
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DIF: Cognitive level: Applying TOP: Nursing process: q q q q


ImplementationMSC: Client Needs: Safe, Effective Care Environment
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4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt.
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Whichintervention is critical in assuring long-term, effective client care as described by
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psychotherapeutic management?
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a. Involvement in group therapies q q q


b. Focus of close supervision by the unit staff q q q q q q q


c. Maintaining effective communication with support system q q q q q


d. Frequently scheduled one-on-one time with nursing staff q q q q q q




ANSWER: D q


A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on-one time with nursing staff will help in establishing
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thisconnection. While the other options are appropriate and client centered, the nurse-client
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relation is critical in the long-term delivery of quality effective care to this client.
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DIF: Cognitive level: Applying TOP: Nursing process: q q q q


ImplementationMSC: Client Needs: Psychosocial Integrity
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5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
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assessment question demonstrates the nurse‘s understanding of the resulting needs of
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theclient?
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a. ―Will you have any difficulty getting your prescription refilled?‖
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b. ―Have you begun experiencing any forms of hallucinations?‖
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c. ―What do you expect will occur since the dosage has been reduced?‖
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d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
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ANSWER: B q


It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
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psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return
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or worsening of positive symptoms such as hallucinations and delusions, and negative
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symptoms such as blunted affect, social withdrawal, and poor grooming. While the other
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options may be appropriate assessment questions, they are not directed at the current needs
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ofthe client; the identification of emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing TOP: Nursing process: q q q q


AssessmentMSC: Client Needs: Physiologic Integrity
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