TESTBANK-KeltnersPsychiatricNursing,9th
z z z z z z
Edition(Steele),
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Chapters1-36|All ChaptersComplete
z z z z z z z z
,
,Chapter01: Med, Meds, Milieu
z z z z
Keltner: Psychiatric Nursing, 8thEdition
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MULTIPLE CHOICE z
1. A newlylicensed asksa nursing recruiter for a descriptionofnursing practice inthe
z z z z z z z z z z z z z z
psychiatric setting. What isthe nurse recruiter‘s best response?
z z z z z z z z z
a. ―The nurse primarilyserves ina supportive role to members ofthe healthcare
z z z z z z z z z z z z z
delivery team.‖ z
b. ―The multidisciplinaryapproacheliminates the needto clearlydefine the
z z z z z z z z z
responsibilities ofnursing in such a setting.‖ z z z z z z
c. ―Nursing actions are identified bythe institutionthat distinguishes nursing from z z z z z z z z z z
other mental health professions.‖ z z z
d. ―Nursing offers unique contributions tothe psychotherapeutic management of z z z z z z z z
psychiatric patients.‖ z
ANSWER: D z
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
z z z z z z z z z z z z z z
applicationofpsychotherapeutic management. Neitherthefacilitynorthe multidisciplinaryteam
z z z z z z z z z z z
define the professional responsibilities of its members but rather utilizes their unique skills to
z z z z z z z z z z z z z z
provide holistic care. Ideally, all team members support each other and have functions within the
z z z z z z z z z z z z z z z
team.
z
DIF: Cognitivelevel: Analyzing TOP: Nursing process: Implementation z z z z z
MSC: Client Needs: Safe, EffectiveCareEnvironment
z z z z z z z
2. Whichcomponent ofthe nursing process willthe nurse focus uponto address the
z z z z z z z z z z z z z
responsibilityto match individualpatient needswithappropriate services?
z z z z z z z z z
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C z
Proper assessment is critical for being able to determine the appropriate level of services that will
z z z z z z z z z z z z z z z
provide optimal care while considering patient input and at the lowest cost. Planning and
z z z z z z z z z z z z z z
implementation utilizes the assessment data to identify and execute actions (treatment plan) that will
z z z z z z z z z z z z z z
provideappropriatecare. Evaluationvalidatestheeffectivenessofthetreatment plan.
z z z z z z z z z z z
DIF: Cognitivelevel: Applying TOP: Nursingprocess: Assessment z z z z z
MSC: Client Needs:Safe, EffectiveCareEnvironment
z z z z z z z
3. Anadult diagnosedwithparanoidschizophrenia frequent experiencesauditoryhallucinationsand
z z z z z z z z z z
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
z z z z z z z z z z z z z
effective psychotherapeutic management ofthis client?
z z z z z z
a. Discussing thedisease process ofschizophrenia withtheclient andtheir domestic z z z z z z z z z z z
partner
b. Minimizingcontact betweenthispatient andother patientsto assure a stress free z z z z z z z z z z z z
milieu
c. AdministeringPRN medicationwhenfirst observingtheevidencethattheclient z z z z z z z z z z
, maybehallucinating z z
d. Independentlydeterminingthat behavior modificationisappropriateto decrease z z z z z z z z
theclient‘sparanoid thoughts
z z z
ANSWER: A z
An understanding of psychopathology is the foundation on which the three components of
z z z z z z z z z z z z
psychotherapeutic management rest;it facilitatestherapeuticcommunicationandprovidesabasis for
z z z z z z z z z z z z
understanding psychopharmacology and milieu management. Minimizing contact between the
z z z z z z z z z
patient and others and administering PRN medication indiscriminately are nontherapeutic
z z z z z z z z z z
interventions. Using behavior modification to decrease the frequency of hallucinationswould need to
z z z z z z z z z z z z z
be incorporatedinto the planofcare bythe care team.
z z z z z z z z z z z
DIF: Cognitivelevel: Applying TOP: Nursing process: Implementation z z z z z
MSC: Client Needs: Safe, EffectiveCareEnvironment
z z z z z z z
4. Anadult diagnosedwithchronicdepressionishospitalized after asuicideattempt.Which
z z z z z z z z z z z z
intervention is critical in assuring long-term, effective client care as described by
z z z z z z z z z z z z
psychotherapeutic management?
z z
a. Involvement ingrouptherapies z z z
b. Focus ofclose supervisionbythe unit staff z z z z z z z
c. Maintainingeffective communicationwithsupportsystem z z z z z
d. Frequentlyscheduled one-on-onetimewithnursing staff z z z z z z
ANSWER: D z
Acriticalelement ofpsychotherapeutic management isthepresenceofatherapeutic
z z z z z z z z z z z
nurse-patient relationship. One-on-onetimewithnursingstaffwillhelp inestablishingthis z z z z z z z z z z z
connection. While the other options are appropriate and client centered, the nurse-client relation is
z z z z z z z z z z z z z z
criticalin the long-termdeliveryofqualityeffective care to this client.
z z z z z z z z z z z z
DIF: Cognitivelevel: Applying TOP: Nursing process: Implementation z z z z z
MSC: Client Needs: Psychosocial Integrity
z z z z z
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
z z z z z z z z z z z z z
assessment questiondemonstratesthenurse‘sunderstanding oftheresulting needsofthe
z z z z z z z z z z z z
client?
z
a. ―Will you have anydifficultygetting your prescriptionrefilled?‖
z z z z z z z z
b. ―Have you begunexperiencing any forms of hallucinations?‖ z z z z z z z
c. ―What do you expect willoccur since the dosage has beenreduced?‖ z z z z z z z z z z z
d. ―What canI doto help you manage this reduction inhaloperidoltherapy?‖ z z z z z z z z z z z z
ANSWER: B z
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
z z z z z z z z z z z z z z z z z
well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
z z z z z z z z z z z z z z z z z z
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
z z z z z z z z z z z z z
affect, social withdrawal, and poor grooming. While the other options maybeappropriate
z z z z z z z z z z z z z
assessment questions,theyarenot directedat thecurrentneedsofthe client;the identificationof
z z z z z z z z z z z z z z z z
emerging psychotic behaviors.
z z z
DIF: Cognitivelevel: Analyzing z z TOP: Nursingprocess: Assessment z z z
MSC: Client Needs: Physiologic Integrity
z z z z z
z z z z z z
Edition(Steele),
z z z
Chapters1-36|All ChaptersComplete
z z z z z z z z
,
,Chapter01: Med, Meds, Milieu
z z z z
Keltner: Psychiatric Nursing, 8thEdition
z z z z
MULTIPLE CHOICE z
1. A newlylicensed asksa nursing recruiter for a descriptionofnursing practice inthe
z z z z z z z z z z z z z z
psychiatric setting. What isthe nurse recruiter‘s best response?
z z z z z z z z z
a. ―The nurse primarilyserves ina supportive role to members ofthe healthcare
z z z z z z z z z z z z z
delivery team.‖ z
b. ―The multidisciplinaryapproacheliminates the needto clearlydefine the
z z z z z z z z z
responsibilities ofnursing in such a setting.‖ z z z z z z
c. ―Nursing actions are identified bythe institutionthat distinguishes nursing from z z z z z z z z z z
other mental health professions.‖ z z z
d. ―Nursing offers unique contributions tothe psychotherapeutic management of z z z z z z z z
psychiatric patients.‖ z
ANSWER: D z
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
z z z z z z z z z z z z z z
applicationofpsychotherapeutic management. Neitherthefacilitynorthe multidisciplinaryteam
z z z z z z z z z z z
define the professional responsibilities of its members but rather utilizes their unique skills to
z z z z z z z z z z z z z z
provide holistic care. Ideally, all team members support each other and have functions within the
z z z z z z z z z z z z z z z
team.
z
DIF: Cognitivelevel: Analyzing TOP: Nursing process: Implementation z z z z z
MSC: Client Needs: Safe, EffectiveCareEnvironment
z z z z z z z
2. Whichcomponent ofthe nursing process willthe nurse focus uponto address the
z z z z z z z z z z z z z
responsibilityto match individualpatient needswithappropriate services?
z z z z z z z z z
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C z
Proper assessment is critical for being able to determine the appropriate level of services that will
z z z z z z z z z z z z z z z
provide optimal care while considering patient input and at the lowest cost. Planning and
z z z z z z z z z z z z z z
implementation utilizes the assessment data to identify and execute actions (treatment plan) that will
z z z z z z z z z z z z z z
provideappropriatecare. Evaluationvalidatestheeffectivenessofthetreatment plan.
z z z z z z z z z z z
DIF: Cognitivelevel: Applying TOP: Nursingprocess: Assessment z z z z z
MSC: Client Needs:Safe, EffectiveCareEnvironment
z z z z z z z
3. Anadult diagnosedwithparanoidschizophrenia frequent experiencesauditoryhallucinationsand
z z z z z z z z z z
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
z z z z z z z z z z z z z
effective psychotherapeutic management ofthis client?
z z z z z z
a. Discussing thedisease process ofschizophrenia withtheclient andtheir domestic z z z z z z z z z z z
partner
b. Minimizingcontact betweenthispatient andother patientsto assure a stress free z z z z z z z z z z z z
milieu
c. AdministeringPRN medicationwhenfirst observingtheevidencethattheclient z z z z z z z z z z
, maybehallucinating z z
d. Independentlydeterminingthat behavior modificationisappropriateto decrease z z z z z z z z
theclient‘sparanoid thoughts
z z z
ANSWER: A z
An understanding of psychopathology is the foundation on which the three components of
z z z z z z z z z z z z
psychotherapeutic management rest;it facilitatestherapeuticcommunicationandprovidesabasis for
z z z z z z z z z z z z
understanding psychopharmacology and milieu management. Minimizing contact between the
z z z z z z z z z
patient and others and administering PRN medication indiscriminately are nontherapeutic
z z z z z z z z z z
interventions. Using behavior modification to decrease the frequency of hallucinationswould need to
z z z z z z z z z z z z z
be incorporatedinto the planofcare bythe care team.
z z z z z z z z z z z
DIF: Cognitivelevel: Applying TOP: Nursing process: Implementation z z z z z
MSC: Client Needs: Safe, EffectiveCareEnvironment
z z z z z z z
4. Anadult diagnosedwithchronicdepressionishospitalized after asuicideattempt.Which
z z z z z z z z z z z z
intervention is critical in assuring long-term, effective client care as described by
z z z z z z z z z z z z
psychotherapeutic management?
z z
a. Involvement ingrouptherapies z z z
b. Focus ofclose supervisionbythe unit staff z z z z z z z
c. Maintainingeffective communicationwithsupportsystem z z z z z
d. Frequentlyscheduled one-on-onetimewithnursing staff z z z z z z
ANSWER: D z
Acriticalelement ofpsychotherapeutic management isthepresenceofatherapeutic
z z z z z z z z z z z
nurse-patient relationship. One-on-onetimewithnursingstaffwillhelp inestablishingthis z z z z z z z z z z z
connection. While the other options are appropriate and client centered, the nurse-client relation is
z z z z z z z z z z z z z z
criticalin the long-termdeliveryofqualityeffective care to this client.
z z z z z z z z z z z z
DIF: Cognitivelevel: Applying TOP: Nursing process: Implementation z z z z z
MSC: Client Needs: Psychosocial Integrity
z z z z z
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
z z z z z z z z z z z z z
assessment questiondemonstratesthenurse‘sunderstanding oftheresulting needsofthe
z z z z z z z z z z z z
client?
z
a. ―Will you have anydifficultygetting your prescriptionrefilled?‖
z z z z z z z z
b. ―Have you begunexperiencing any forms of hallucinations?‖ z z z z z z z
c. ―What do you expect willoccur since the dosage has beenreduced?‖ z z z z z z z z z z z
d. ―What canI doto help you manage this reduction inhaloperidoltherapy?‖ z z z z z z z z z z z z
ANSWER: B z
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
z z z z z z z z z z z z z z z z z
well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
z z z z z z z z z z z z z z z z z z
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
z z z z z z z z z z z z z
affect, social withdrawal, and poor grooming. While the other options maybeappropriate
z z z z z z z z z z z z z
assessment questions,theyarenot directedat thecurrentneedsofthe client;the identificationof
z z z z z z z z z z z z z z z z
emerging psychotic behaviors.
z z z
DIF: Cognitivelevel: Analyzing z z TOP: Nursingprocess: Assessment z z z
MSC: Client Needs: Physiologic Integrity
z z z z z
