TEST BANK - Keltners Psychiatric Nursing, 9th
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q2 Edition (Steele),
q2 q2
Chapters 1 - 36 | All Chapters Complete
q2 q2 q2 q2 q2 q2 q2 q2
,
,Chapter 01: Med, Meds, Milieu
q2 q2 q2 q2
Keltner: Psychiatric Nursing, 8thEdition
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MULTIPLE CHOICE q2
1. A newly licensed asks a nursing recruiter for a description ofnursing practice inthe
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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
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
delivery team.‖ q2
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
q2 q2 q2 q2 q2 q2 q2 q2 q2
responsibilities of nursing in such a setting.‖ q2 q2 q2 q2 q2 q2
c. ―Nursing actions are identified by the institution that distinguishes nursing from q2 q2 q2 q2 q2 q2 q2 q 2 q2 q2
other mental health professions.‖ q 2 q2 q2
d. ―Nursing offers unique contributions to the psychotherapeutic management of q2 q2 q2 q2 q2 q2 q2 q2
psychiatric patients.‖ q 2
ANSWER: D q 2
Professional role overlap cannot be denied; however, nursing is unique in its focus on and q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
applicationofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
define the professional responsibilities of its members but rather utilizes their unique skills to
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
provide holistic care. Ideally, all team members support each other and have functions within the
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
team.
q2
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation q2 q2 q 2 q2 q2
MSC: Client Needs: Safe, Effective Care Environment
q2 q 2 q2 q2 q2 q2 q2
2. Which component ofthe nursing process willthe nurse focus upon to address the
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
responsibility to match individualpatient needs with appropriate services?
q2 q2 q2 q2 q2 q2 q2 q2 q2
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C q 2
Proper assessment is critical for being able to determine the appropriate level of services that will
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
provide optimal care while considering patient input and at the lowest cost. Planning and
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
willprovide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
DIF: Cognitive level: Applying TOP: Nursing process: Assessment q2 q2 q 2 q2 q2
MSC: Client Needs: Safe, Effective Care Environment
q2 q 2 q2 q2 q2 q2 q2
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
effective psychotherapeutic management of this client?
q2 q2 q2 q2 q2 q2
a. Discussing the disease process of schizophrenia withthe client and their domestic q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
partner
b. Minimizing contact betweenthis patient and other patients to assure a stress free q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
milieu
c. Administering PRN medicationwhen first observing the evidence that the client q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
, may be hallucinating q2 q2
d. Independentlydetermining that behavior modification is appropriate to decrease q2 q2 q2 q2 q2 q2 q2 q2
the client‘s paranoid thoughts
q2 q2 q2
ANSWER: A q 2
An understanding of psychopathology is the foundation on which the three components of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
psychotherapeutic management rest; it facilitates therapeutic communicationand provides abasis
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
for understanding psychopharmacology and milieu management. Minimizing contact between the
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
patient and others and administering PRN medication indiscriminately are nontherapeutic
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
interventions. Using behavior modification to decrease the frequency of hallucinations would need
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
to be incorporated into the plan ofcare by the care team.
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
DIF: Cognitive level: Applying TOP: Nursing process: Implementation q2 q2 q 2 q2 q2
MSC: Client Needs: Safe, Effective Care Environment
q2 q 2 q2 q2 q2 q2 q2
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
intervention is critical in assuring long-term, effective client care as described by
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
psychotherapeutic management?
q2 q2
a. Involvement ingroup therapies q2 q2 q2
b. Focus of close supervision by the unit staff q2 q2 q2 q2 q2 q2 q2
c. Maintaining effective communicationwith support system q2 q2 q2 q2 q2
d. Frequentlyscheduled one-on-one time with nursing staff q2 q2 q2 q2 q2 q2
ANSWER: D q 2
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
connection. While the other options are appropriate and client centered, the nurse-client relation is
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
critical in the long-termdeliveryofqualityeffective care to this client.
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
DIF: Cognitive level: Applying TOP: Nursing process: Implementation q2 q2 q 2 q2 q2
MSC: Client Needs: Psychosocial Integrity
q2 q 2 q2 q2 q2
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
assessment questiondemonstratesthe nurse‘s understanding ofthe resulting needs ofthe
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
client?
q2
a. ―Will you have any difficultygetting your prescription refilled?‖q2 q2 q2 q2 q2 q2 q2 q2
b. ―Have you begun experiencing any forms of hallucinations?‖ q2 q2 q2 q2 q2 q2 q2
c. ―What do you expect willoccur since the dosage has been reduced?‖ q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
ANSWER: B q 2
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
assessment questions, theyare not directed at the current needs ofthe client; the identification of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
emerging psychotic behaviors.
q2 q2 q2
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment q2 q2 q 2 q2 q2
MSC: Client Needs: Physiologic Integrity
q2 q 2 q2 q2 q2
q2 q2 q2 q2 q2 q2
q2 Edition (Steele),
q2 q2
Chapters 1 - 36 | All Chapters Complete
q2 q2 q2 q2 q2 q2 q2 q2
,
,Chapter 01: Med, Meds, Milieu
q2 q2 q2 q2
Keltner: Psychiatric Nursing, 8thEdition
q2 q2 q2 q2
MULTIPLE CHOICE q2
1. A newly licensed asks a nursing recruiter for a description ofnursing practice inthe
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
psychiatric setting. What is the nurse recruiter‘s best response?
q2 q2 q2 q 2 q2 q2 q2 q2 q2
a. ―The nurse primarily serves in a supportive role to members of the health care
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
delivery team.‖ q2
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
q2 q2 q2 q2 q2 q2 q2 q2 q2
responsibilities of nursing in such a setting.‖ q2 q2 q2 q2 q2 q2
c. ―Nursing actions are identified by the institution that distinguishes nursing from q2 q2 q2 q2 q2 q2 q2 q 2 q2 q2
other mental health professions.‖ q 2 q2 q2
d. ―Nursing offers unique contributions to the psychotherapeutic management of q2 q2 q2 q2 q2 q2 q2 q2
psychiatric patients.‖ q 2
ANSWER: D q 2
Professional role overlap cannot be denied; however, nursing is unique in its focus on and q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
applicationofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
define the professional responsibilities of its members but rather utilizes their unique skills to
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
provide holistic care. Ideally, all team members support each other and have functions within the
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
team.
q2
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation q2 q2 q 2 q2 q2
MSC: Client Needs: Safe, Effective Care Environment
q2 q 2 q2 q2 q2 q2 q2
2. Which component ofthe nursing process willthe nurse focus upon to address the
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
responsibility to match individualpatient needs with appropriate services?
q2 q2 q2 q2 q2 q2 q2 q2 q2
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C q 2
Proper assessment is critical for being able to determine the appropriate level of services that will
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
provide optimal care while considering patient input and at the lowest cost. Planning and
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
willprovide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
DIF: Cognitive level: Applying TOP: Nursing process: Assessment q2 q2 q 2 q2 q2
MSC: Client Needs: Safe, Effective Care Environment
q2 q 2 q2 q2 q2 q2 q2
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
effective psychotherapeutic management of this client?
q2 q2 q2 q2 q2 q2
a. Discussing the disease process of schizophrenia withthe client and their domestic q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
partner
b. Minimizing contact betweenthis patient and other patients to assure a stress free q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
milieu
c. Administering PRN medicationwhen first observing the evidence that the client q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
, may be hallucinating q2 q2
d. Independentlydetermining that behavior modification is appropriate to decrease q2 q2 q2 q2 q2 q2 q2 q2
the client‘s paranoid thoughts
q2 q2 q2
ANSWER: A q 2
An understanding of psychopathology is the foundation on which the three components of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
psychotherapeutic management rest; it facilitates therapeutic communicationand provides abasis
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
for understanding psychopharmacology and milieu management. Minimizing contact between the
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
patient and others and administering PRN medication indiscriminately are nontherapeutic
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
interventions. Using behavior modification to decrease the frequency of hallucinations would need
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
to be incorporated into the plan ofcare by the care team.
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
DIF: Cognitive level: Applying TOP: Nursing process: Implementation q2 q2 q 2 q2 q2
MSC: Client Needs: Safe, Effective Care Environment
q2 q 2 q2 q2 q2 q2 q2
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
intervention is critical in assuring long-term, effective client care as described by
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
psychotherapeutic management?
q2 q2
a. Involvement ingroup therapies q2 q2 q2
b. Focus of close supervision by the unit staff q2 q2 q2 q2 q2 q2 q2
c. Maintaining effective communicationwith support system q2 q2 q2 q2 q2
d. Frequentlyscheduled one-on-one time with nursing staff q2 q2 q2 q2 q2 q2
ANSWER: D q 2
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
connection. While the other options are appropriate and client centered, the nurse-client relation is
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
critical in the long-termdeliveryofqualityeffective care to this client.
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
DIF: Cognitive level: Applying TOP: Nursing process: Implementation q2 q2 q 2 q2 q2
MSC: Client Needs: Psychosocial Integrity
q2 q 2 q2 q2 q2
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
assessment questiondemonstratesthe nurse‘s understanding ofthe resulting needs ofthe
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
client?
q2
a. ―Will you have any difficultygetting your prescription refilled?‖q2 q2 q2 q2 q2 q2 q2 q2
b. ―Have you begun experiencing any forms of hallucinations?‖ q2 q2 q2 q2 q2 q2 q2
c. ―What do you expect willoccur since the dosage has been reduced?‖ q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
ANSWER: B q 2
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
assessment questions, theyare not directed at the current needs ofthe client; the identification of
q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2 q2
emerging psychotic behaviors.
q2 q2 q2
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment q2 q2 q 2 q2 q2
MSC: Client Needs: Physiologic Integrity
q2 q 2 q2 q2 q2
