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