/f
, Psychiatric Nursing 8th EditionlKeltnerlTestlBank
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Chapter01:Med,Meds,Milieu
/f /f /f /f
Keltner:PsychiatricNursing,8thEdition
/f /f /f
MULTIPLECHOICE
1. Anewlylicensedasksanursinglrecruiterforadescriptionofnursinglpracticelinthelpsyc /f
/ f hiatricsetting.Whatisthelnurselrecruiter‟sbestresponse?
/f /f /f
a. “Thelnurselprimarilyservesinlasupportiveroletomembersofthehealthcaredeli / f
/ f veryteam.”
b. “Themultidisciplinaryapproacheliminateslthelneedtolclearlydefineltheres
/ f ponsibilitiesofnursinginsuchasetting.”
c. “Nursinglactionslarelidentifiedbytheinstitutionthatdistinguishesnursinglfromoth /f
/f ermentallhealthprofessions.”
/f /f
d. “Nursingloffersluniquecontributionstothepsychotherapeuticmanagementofps /f
/f ychiatricpatients.”
ANS: D /f
Professionalroleoverlap cannotlbedenied; however, nursingisluniquelinits focusonandlapplic /f /f /f /f
ationlofpsychotherapeuticlmanagement.Neitherthelfacilitynorthelmultidisciplinaryteamdefi
/f /f
netheprofessionalresponsibilitiesofitsmembersbutratherutilizestheiruniqueskillstolprovi
/f /f /f
/ deholisticlcare. Ideally, all teamlmemberssupporteachlotherandhavefunctionswithinltheltea
f /f /f /f
m.
/ f
DIF: Cognitivellevel: Analyzing /f
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:Safe,EffectivelCar
/f /f /f /f /f /f
/f elEnvironment
2. Which l component of the l nur sinUg pS
ro ceNs s w
Till theOnursefocusuponltoladdressltheresp N R I G B.C M /f /f /f /f
onsibilitytolmatchindividualpatientneedswithappropriateservices? /f
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: C /f
Properassessmentislcritical forbeinglabletodeterminetheappropriatelevelofservicesthatlwillp /f /f /f
rovideoptimalcarelwhilelconsideringpatientinputandatthelowestlcost.Planningandimplement
/f /f /f /f
ationlutilizeslthelassessmentdataltoidentifyandexecuteactions(treatmentplan)thatwillprovide
/f /f /f /f
appropriatecare.Evaluation validatestheleffectiveness ofthetreatmentplan.
/f /f /f /f
DIF: Cognitivellevel: Applying /f
TOP: Nursingprocess:AssessmentlMSC: ClientNeeds:Safe,EffectiveCa
/f /f /f /f /f /f /f
/f reEnvironment
/f
3. An adultdiagnosedwithparanoidschizophreniafrequentlexperienceslauditoryhallucinationsan
/f
dwalksabouttheunit, muttering. Whichnursingactionldemonstratesthenurse‟s understandingl
/f /f /f /f
ofeffectivepsychotherapeuticmanagementofthisclient?
/ f
a. Discussingthediseaseprocesslofschizophreniawiththeclientandltheirdomesticlpar / f
tner / f
b. Minimizingcontactbetweenthispatientandotherpatientstoassurelastressfreemili /f
eu / f
c. Administering PRNmedicationwhenlfirstobservingtheevidencelthattheclient / f
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maybehallucinating
d. Independentlydeterminingthatlbehaviormodificationlisappropriatetoldecreaseth
/ f eclient‟slparanoidthoughts /f
ANS: A /f
Anunderstandinglofpsychopathologyislthelfoundationonlwhichthethreecomponentsofpsyc
/f
hotherapeuticlmanagementrest; itfacilitatestherapeuticcommunicationandprovidesabasis fo
/f /f /f /f /f
runderstandinglpsychopharmacologyandlmilieulmanagement.Minimizingcontactbetweenth
/f /f /f
epatientandlothersandadministeringPRNmedicationindiscriminatelyarenontherapeuticint
/f /f
erventions.Usinglbehaviormodificationltodecrease thefrequencyofhallucinationslwouldnee
/ f /f /f /f
dtobeincorporatedintotheplanofcarelbythecareteam.
/f
DIF: Cognitivellevel: Applying /f
TOP: Nursingprocess:ImplementationMSC: ClientlNeeds:Safe,EffectiveCa
/f /f / f /f /f /f
/f reEnvironment
/f
4. Anadultldiagnosedwithchronicldepressionishospitalizedafterasuicidelattempt. Whichinte
/f /f /f
rventionliscriticalinassuringllong-
/f /f /f
term,effectiveclientcareasldescribedbypsychotherapeuticmanagement?
/f /f /f /f
a. Involvementingrouptherapies
b. Focusofcloselsupervisionbythelunitlstaff /f
c. Maintainingeffectivecommunicationwithsupportsystem
d. Frequentlyscheduledlone-on-oneltimewithnursinglstaff
ANS: D /f
Acriticallelementofpsychotherapeuticmanagementlisthepresenceofatherapeutic / f
/ nurse-patientrelationship.One-on-
f /f /f
onetimelwithnursinglstaffwillhelplinestablishingthislconnection.Whiletheotheroptionsare /f
appropriateandlclientcentered,thenurse-clientrelationiscriticali n l the l longN
- /f /f /f /f /f /f
RSdeIliNveGrT
teUrm
/f yB
of.qC
uaOliM
tyeffectivecaretothislclient. /f
DIF: Cognitivellevel: Applying /f
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:PsychosocialInte
/f /f /f /f /f /f
grity
5. Apatient‟shaloperidoldosagelwaslreduced2weekslagotodecreasesideleffects.Whatasses
/f /f /f /f /f /f
smentquestiondemonstrateslthelnurse‟sunderstandingloftheresultingneedsoftheclient?
/f /f
a. “Willyouhaveanydifficultygetting yourprescriptionlrefilled?” / f
b. “Have youbegunexperiencinganyformsofhallucinations?”
/f
c. “Whatdoyouexpect willoccursincethedosagelhasbeenreduced?” /f
d. “Whatcan Ildotohelp youmanagethisreductionlinlhaloperidoltherapy?”
/f /f /f /f /f
ANS: B /f
It willbelnecessaryforthenurseltoassessforexacerbation ofthelpatient‟s symptoms ofpsychosis
/f /f /f /f
as well as foralesseningofsideeffects. Dosagedecreasemightleadtothereturnorworseningofp
/f /f /f /f /f
ositivelsymptoms suchlas hallucinationslanddelusions, andnegativelsymptomslsuch as blunted af
/f /f /f /f /f /f /f
fect, socialwithdrawal, andpoorgrooming. Whiletheotheroptionsmaybelappropriatelassessme
/f /f /f /f
ntquestions, theyarelnot directed at thecurrentneeds oftheclient; thelidentification ofemerginglp
/f /f /f /f /f /f /f /f
sychoticbehaviors.
/f
DIF: Cognitivellevel: Analyzing /f
TOP: Nursingprocess:AssessmentMSC: ClientNeeds:PhysiologicIntegr
/f /f /f /f /f /f
ity
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6. Whichstatementformsthefoundationuponwhichanurseshouldbasetheimplementationofpsy /f
/ chotherapeuticmanagementltothelcarelofapatientwithlmentalillness?
f
a. Thenurse‟s roleinclientcareissupportedbythemultidisciplinaryteam.
/ f / f
b. Omittinganyonecomponentwillcompromiseltheleffectivenessoftheltreatment.
c. Themostlimportantlelementofpsychotherapeuticmanagementlisdrugtherapy.
d. Atherapeuticnurse-patient relationshipisthemostimportantaspectoftreatment. / f
ANS: B /f
Whenoneelementismissing, treatmentisusuallycompromised. No singleelementlismoreimpo /f /f /f
rtantlthanlthelothers; however, patients‟ needslgovernlthelapplication ofthelcomponentsandperm
/f /f /f /f /f
it judiciousluse. Theremainingoptionsidentifycomponents ofthepsychotherapeuticmanageme
/f /f /f /f
ntprocess.
/f
DIF: Cognitivellevel:Analyzing
/ f / f /f
TOP: Nursingprocess:AnalysisMSC: ClientNeeds:Safe,EffectivelCa
/f /f /f /f /f /f
/f reEnvironment
/f
7. Whichlstatementmostlaccuratelydescribesalnurse‟slrolelregarding psychopharmacology? /f
a. “YouwillneedtofrequentlymakedecisionsregardingtheadministrationofPRNme /f
dicationstolhelplthelclientlmanageanger.”
/ f
b. “It‟sanursinglresponsibilitytoadjustamedicationdoseltoassureleffectivelpatientresp
/f /f
onses.” /f
c. “Nursesadministersmedicationswhileevaluatingdrugleffectivenessislamedicalres
/f
ponsibility.”
/f
d. “Tobestassureappropriateresponse,apatient‟squestionsaboutdrugtherapysho /f /f
uldbelreferredltolthelpsychiatrist.”
/f
ANS: A /f
Nursing l assessment and l analN isRoS
y sU f l dIaN
taGmTigBh.
t l sCuO
ggMest theneedforPRNmedicationaspatienta /f /f /f
nxietyincreasesorpsychoticlsymptoms becomelmorelacute.Thelnurselisthehealth
/f /f /f /f
teammemberwholmakeslthisdetermination. Nursesareresponsibleformonitoringdrugleffective /f
ness aslwell as administeringmedication. Nurseslshould assumeresponsibilityforteachingpatien
/f /f /f /f /f /f
tslaboutlthelsideeffects ofmedications. Nurseslcannotalterprescribeddosagesofmedicationslunle
/f /f /f
sstheyhaveprescriptiveprivileges.
/f
DIF: Cognitivellevel:Analyzing
/ f / f /f
TOP: Nursingprocess:AnalysisMSC: ClientlNeeds:Safe,EffectivelCa
/f /f /f /f /f
/f reEnvironment
/f
8. Whenconsideringenvironmental aspectsofmilieulmanagement,whichlintervention hasthehig /f /f /f
hest priorityforaclient admittedlafteralfailed suicidelattempt?
/f /f /f /f
a. Sendingthelclient‟s newmedicationprescriptionslto thelpharmacy /f /f
b. Assigningastaffmembertoone-on-oneobservationofthelclient
c. Orientingltheclient tothemilieu‟slpublic andprivatespaces /f /f
d. Havinglallpotentiallydangerousitemsremovedfromtheclient‟s belongings
/f /f
ANS: B /f
Milieumanagementprovides alproactivelapproachtolcare. Safetyoverridesallotherdimension /f /f
softhelmilieu. Initiation of suicideprecautionsarethelpriorityforthisclient. Alltheremaininglo
/f /f /f /f /f
ptionsareappropriatebutlnoneprotecttheclientfromtheriskofanotherattemptltoself-
/f
harm asleffectivelyas one-on-onelobservationlas partofsuicideprecautions.
/f /f /f /f
DIF: / f / f Cognitivellevel:Analyzing /f TOP: Nursingprocess:Implementation
/f /f
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Chapter01:Med,Meds,Milieu
/f /f /f /f
Keltner:PsychiatricNursing,8thEdition
/f /f /f
MULTIPLECHOICE
1. Anewlylicensedasksanursinglrecruiterforadescriptionofnursinglpracticelinthelpsyc /f
/ f hiatricsetting.Whatisthelnurselrecruiter‟sbestresponse?
/f /f /f
a. “Thelnurselprimarilyservesinlasupportiveroletomembersofthehealthcaredeli / f
/ f veryteam.”
b. “Themultidisciplinaryapproacheliminateslthelneedtolclearlydefineltheres
/ f ponsibilitiesofnursinginsuchasetting.”
c. “Nursinglactionslarelidentifiedbytheinstitutionthatdistinguishesnursinglfromoth /f
/f ermentallhealthprofessions.”
/f /f
d. “Nursingloffersluniquecontributionstothepsychotherapeuticmanagementofps /f
/f ychiatricpatients.”
ANS: D /f
Professionalroleoverlap cannotlbedenied; however, nursingisluniquelinits focusonandlapplic /f /f /f /f
ationlofpsychotherapeuticlmanagement.Neitherthelfacilitynorthelmultidisciplinaryteamdefi
/f /f
netheprofessionalresponsibilitiesofitsmembersbutratherutilizestheiruniqueskillstolprovi
/f /f /f
/ deholisticlcare. Ideally, all teamlmemberssupporteachlotherandhavefunctionswithinltheltea
f /f /f /f
m.
/ f
DIF: Cognitivellevel: Analyzing /f
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:Safe,EffectivelCar
/f /f /f /f /f /f
/f elEnvironment
2. Which l component of the l nur sinUg pS
ro ceNs s w
Till theOnursefocusuponltoladdressltheresp N R I G B.C M /f /f /f /f
onsibilitytolmatchindividualpatientneedswithappropriateservices? /f
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: C /f
Properassessmentislcritical forbeinglabletodeterminetheappropriatelevelofservicesthatlwillp /f /f /f
rovideoptimalcarelwhilelconsideringpatientinputandatthelowestlcost.Planningandimplement
/f /f /f /f
ationlutilizeslthelassessmentdataltoidentifyandexecuteactions(treatmentplan)thatwillprovide
/f /f /f /f
appropriatecare.Evaluation validatestheleffectiveness ofthetreatmentplan.
/f /f /f /f
DIF: Cognitivellevel: Applying /f
TOP: Nursingprocess:AssessmentlMSC: ClientNeeds:Safe,EffectiveCa
/f /f /f /f /f /f /f
/f reEnvironment
/f
3. An adultdiagnosedwithparanoidschizophreniafrequentlexperienceslauditoryhallucinationsan
/f
dwalksabouttheunit, muttering. Whichnursingactionldemonstratesthenurse‟s understandingl
/f /f /f /f
ofeffectivepsychotherapeuticmanagementofthisclient?
/ f
a. Discussingthediseaseprocesslofschizophreniawiththeclientandltheirdomesticlpar / f
tner / f
b. Minimizingcontactbetweenthispatientandotherpatientstoassurelastressfreemili /f
eu / f
c. Administering PRNmedicationwhenlfirstobservingtheevidencelthattheclient / f
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maybehallucinating
d. Independentlydeterminingthatlbehaviormodificationlisappropriatetoldecreaseth
/ f eclient‟slparanoidthoughts /f
ANS: A /f
Anunderstandinglofpsychopathologyislthelfoundationonlwhichthethreecomponentsofpsyc
/f
hotherapeuticlmanagementrest; itfacilitatestherapeuticcommunicationandprovidesabasis fo
/f /f /f /f /f
runderstandinglpsychopharmacologyandlmilieulmanagement.Minimizingcontactbetweenth
/f /f /f
epatientandlothersandadministeringPRNmedicationindiscriminatelyarenontherapeuticint
/f /f
erventions.Usinglbehaviormodificationltodecrease thefrequencyofhallucinationslwouldnee
/ f /f /f /f
dtobeincorporatedintotheplanofcarelbythecareteam.
/f
DIF: Cognitivellevel: Applying /f
TOP: Nursingprocess:ImplementationMSC: ClientlNeeds:Safe,EffectiveCa
/f /f / f /f /f /f
/f reEnvironment
/f
4. Anadultldiagnosedwithchronicldepressionishospitalizedafterasuicidelattempt. Whichinte
/f /f /f
rventionliscriticalinassuringllong-
/f /f /f
term,effectiveclientcareasldescribedbypsychotherapeuticmanagement?
/f /f /f /f
a. Involvementingrouptherapies
b. Focusofcloselsupervisionbythelunitlstaff /f
c. Maintainingeffectivecommunicationwithsupportsystem
d. Frequentlyscheduledlone-on-oneltimewithnursinglstaff
ANS: D /f
Acriticallelementofpsychotherapeuticmanagementlisthepresenceofatherapeutic / f
/ nurse-patientrelationship.One-on-
f /f /f
onetimelwithnursinglstaffwillhelplinestablishingthislconnection.Whiletheotheroptionsare /f
appropriateandlclientcentered,thenurse-clientrelationiscriticali n l the l longN
- /f /f /f /f /f /f
RSdeIliNveGrT
teUrm
/f yB
of.qC
uaOliM
tyeffectivecaretothislclient. /f
DIF: Cognitivellevel: Applying /f
TOP: Nursingprocess:ImplementationMSC: ClientNeeds:PsychosocialInte
/f /f /f /f /f /f
grity
5. Apatient‟shaloperidoldosagelwaslreduced2weekslagotodecreasesideleffects.Whatasses
/f /f /f /f /f /f
smentquestiondemonstrateslthelnurse‟sunderstandingloftheresultingneedsoftheclient?
/f /f
a. “Willyouhaveanydifficultygetting yourprescriptionlrefilled?” / f
b. “Have youbegunexperiencinganyformsofhallucinations?”
/f
c. “Whatdoyouexpect willoccursincethedosagelhasbeenreduced?” /f
d. “Whatcan Ildotohelp youmanagethisreductionlinlhaloperidoltherapy?”
/f /f /f /f /f
ANS: B /f
It willbelnecessaryforthenurseltoassessforexacerbation ofthelpatient‟s symptoms ofpsychosis
/f /f /f /f
as well as foralesseningofsideeffects. Dosagedecreasemightleadtothereturnorworseningofp
/f /f /f /f /f
ositivelsymptoms suchlas hallucinationslanddelusions, andnegativelsymptomslsuch as blunted af
/f /f /f /f /f /f /f
fect, socialwithdrawal, andpoorgrooming. Whiletheotheroptionsmaybelappropriatelassessme
/f /f /f /f
ntquestions, theyarelnot directed at thecurrentneeds oftheclient; thelidentification ofemerginglp
/f /f /f /f /f /f /f /f
sychoticbehaviors.
/f
DIF: Cognitivellevel: Analyzing /f
TOP: Nursingprocess:AssessmentMSC: ClientNeeds:PhysiologicIntegr
/f /f /f /f /f /f
ity
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6. Whichstatementformsthefoundationuponwhichanurseshouldbasetheimplementationofpsy /f
/ chotherapeuticmanagementltothelcarelofapatientwithlmentalillness?
f
a. Thenurse‟s roleinclientcareissupportedbythemultidisciplinaryteam.
/ f / f
b. Omittinganyonecomponentwillcompromiseltheleffectivenessoftheltreatment.
c. Themostlimportantlelementofpsychotherapeuticmanagementlisdrugtherapy.
d. Atherapeuticnurse-patient relationshipisthemostimportantaspectoftreatment. / f
ANS: B /f
Whenoneelementismissing, treatmentisusuallycompromised. No singleelementlismoreimpo /f /f /f
rtantlthanlthelothers; however, patients‟ needslgovernlthelapplication ofthelcomponentsandperm
/f /f /f /f /f
it judiciousluse. Theremainingoptionsidentifycomponents ofthepsychotherapeuticmanageme
/f /f /f /f
ntprocess.
/f
DIF: Cognitivellevel:Analyzing
/ f / f /f
TOP: Nursingprocess:AnalysisMSC: ClientNeeds:Safe,EffectivelCa
/f /f /f /f /f /f
/f reEnvironment
/f
7. Whichlstatementmostlaccuratelydescribesalnurse‟slrolelregarding psychopharmacology? /f
a. “YouwillneedtofrequentlymakedecisionsregardingtheadministrationofPRNme /f
dicationstolhelplthelclientlmanageanger.”
/ f
b. “It‟sanursinglresponsibilitytoadjustamedicationdoseltoassureleffectivelpatientresp
/f /f
onses.” /f
c. “Nursesadministersmedicationswhileevaluatingdrugleffectivenessislamedicalres
/f
ponsibility.”
/f
d. “Tobestassureappropriateresponse,apatient‟squestionsaboutdrugtherapysho /f /f
uldbelreferredltolthelpsychiatrist.”
/f
ANS: A /f
Nursing l assessment and l analN isRoS
y sU f l dIaN
taGmTigBh.
t l sCuO
ggMest theneedforPRNmedicationaspatienta /f /f /f
nxietyincreasesorpsychoticlsymptoms becomelmorelacute.Thelnurselisthehealth
/f /f /f /f
teammemberwholmakeslthisdetermination. Nursesareresponsibleformonitoringdrugleffective /f
ness aslwell as administeringmedication. Nurseslshould assumeresponsibilityforteachingpatien
/f /f /f /f /f /f
tslaboutlthelsideeffects ofmedications. Nurseslcannotalterprescribeddosagesofmedicationslunle
/f /f /f
sstheyhaveprescriptiveprivileges.
/f
DIF: Cognitivellevel:Analyzing
/ f / f /f
TOP: Nursingprocess:AnalysisMSC: ClientlNeeds:Safe,EffectivelCa
/f /f /f /f /f
/f reEnvironment
/f
8. Whenconsideringenvironmental aspectsofmilieulmanagement,whichlintervention hasthehig /f /f /f
hest priorityforaclient admittedlafteralfailed suicidelattempt?
/f /f /f /f
a. Sendingthelclient‟s newmedicationprescriptionslto thelpharmacy /f /f
b. Assigningastaffmembertoone-on-oneobservationofthelclient
c. Orientingltheclient tothemilieu‟slpublic andprivatespaces /f /f
d. Havinglallpotentiallydangerousitemsremovedfromtheclient‟s belongings
/f /f
ANS: B /f
Milieumanagementprovides alproactivelapproachtolcare. Safetyoverridesallotherdimension /f /f
softhelmilieu. Initiation of suicideprecautionsarethelpriorityforthisclient. Alltheremaininglo
/f /f /f /f /f
ptionsareappropriatebutlnoneprotecttheclientfromtheriskofanotherattemptltoself-
/f
harm asleffectivelyas one-on-onelobservationlas partofsuicideprecautions.
/f /f /f /f
DIF: / f / f Cognitivellevel:Analyzing /f TOP: Nursingprocess:Implementation
/f /f
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