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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
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?
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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?
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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 |frequent |experiences |auditory |hallucinations
and |walks |about |the |unit, |muttering. |Which |nursing |action |demonstrates |the |nurse‘s
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|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
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|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; |the
|identification |of |emerging |psychotic |behaviors.
DIF: Cognitive |level: |Analyzing TOP: | Nursing |process: |Assessment
|MSC: | Client |Needs: |Physiologic |Integrity