TEST BANK - Keltners Psychiatric Nursing,
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
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?
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?
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
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 idetermining ithat ibehavior imodification iis iappropriate ito idecrease
the iclient‘s iparanoid ithoughts
ANSWER: i A
An iunderstanding iof ipsychopathology iis ithe ifoundation ion iwhich ithe ithree icomponents iof
ipsychotherapeutic imanagement irest; iit ifacilitates itherapeutic icommunication iand iprovides
iaibasis ifor iunderstanding ipsychopharmacology iand imilieu imanagement. iMinimizing icontact
ibetween ithe ipatient iand iothers iand iadministering iPRN imedication iindiscriminately iare
inontherapeutic iinterventions. iUsing ibehavior imodification ito idecrease ithe ifrequency iof
ihallucinations iwould ineed ito i be iincorporated iinto ithe iplan iof icare iby ithe icare iteam.
DIF: Cognitive ilevel: iApplying TOP: i Nursing iprocess:
iImplementationiMSC: i Client iNeeds: iSafe, iEffective iCare iEnvironment
4. An iadult idiagnosed iwith ichronic idepression iis ihospitalized iafter ia isuicide iattempt.
iWhichiintervention iis icritical iin iassuring ilong-term, ieffective iclient icare ias idescribed
iby ipsychotherapeutic i management?
a. Involvement iin igroup itherapies
b. Focus iof iclose isupervision iby ithe iunit i staff
c. Maintaining ieffective icommunication iwith isupport isystem
d. Frequently ischeduled ione-on-one itime iwith inursing istaff
ANSWER: i D
A icritical ielement iof ipsychotherapeutic imanagement iis ithe ipresence iof ia itherapeutic
nurse-patient irelationship. iOne-on-one itime iwith inursing istaff iwill ihelp iin iestablishing
ithisiconnection. iWhile ithe iother ioptions iare iappropriate iand iclient icentered, ithe inurse-
client irelation iis icritical iin ithe i long-term idelivery iof iquality ieffective icare ito ithis iclient.
DIF: Cognitive ilevel: iApplying TOP: i Nursing iprocess:
iImplementationiMSC: i Client iNeeds: iPsychosocial iIntegrity
5. A ipatient‘s ihaloperidol idosage iwas ireduced i2 iweeks iago ito idecrease iside ieffects.
iWhat iassessment iquestion idemonstrates ithe inurse‘s iunderstanding iof ithe iresulting
ineeds iof itheiclient?
a. ―Will iyou ihave iany idifficulty igetting i your iprescription irefilled?‖
b. ―Have i you ibegun iexperiencing iany iforms iof ihallucinations?‖
c. ―What i do iyou iexpect i will ioccur isince ithe idosage ihas ibeen ireduced?‖
d. ―What i can iI ido ito i help iyou imanage ithis ireduction iin ihaloperidol
itherapy?‖
ANSWER: i B
It iwill ibe inecessary ifor ithe inurse ito iassess ifor iexacerbation iof ithe ipatient‘s isymptoms iof
ipsychosis ias iwell ias ifor ia ilessening iof iside ieffects. iDosage idecrease imight ilead ito ithe
ireturn ior iworsening iof ipositive isymptoms isuch ias ihallucinations iand idelusions, iand
inegative isymptoms isuch ias iblunted iaffect, isocial iwithdrawal, iand ipoor igrooming. iWhile
ithe iother ioptions imay ibe iappropriate iassessment iquestions, ithey iare inot idirected iat ithe
icurrent ineeds iofithe iclient; ithe iidentification iof iemerging ipsychotic ibehaviors.
DIF: Cognitive ilevel: iAnalyzing TOP: i Nursing iprocess:
iAssessmentiMSC: i Client iNeeds: iPhysiologic iIntegrity
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
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?
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?
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
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 idetermining ithat ibehavior imodification iis iappropriate ito idecrease
the iclient‘s iparanoid ithoughts
ANSWER: i A
An iunderstanding iof ipsychopathology iis ithe ifoundation ion iwhich ithe ithree icomponents iof
ipsychotherapeutic imanagement irest; iit ifacilitates itherapeutic icommunication iand iprovides
iaibasis ifor iunderstanding ipsychopharmacology iand imilieu imanagement. iMinimizing icontact
ibetween ithe ipatient iand iothers iand iadministering iPRN imedication iindiscriminately iare
inontherapeutic iinterventions. iUsing ibehavior imodification ito idecrease ithe ifrequency iof
ihallucinations iwould ineed ito i be iincorporated iinto ithe iplan iof icare iby ithe icare iteam.
DIF: Cognitive ilevel: iApplying TOP: i Nursing iprocess:
iImplementationiMSC: i Client iNeeds: iSafe, iEffective iCare iEnvironment
4. An iadult idiagnosed iwith ichronic idepression iis ihospitalized iafter ia isuicide iattempt.
iWhichiintervention iis icritical iin iassuring ilong-term, ieffective iclient icare ias idescribed
iby ipsychotherapeutic i management?
a. Involvement iin igroup itherapies
b. Focus iof iclose isupervision iby ithe iunit i staff
c. Maintaining ieffective icommunication iwith isupport isystem
d. Frequently ischeduled ione-on-one itime iwith inursing istaff
ANSWER: i D
A icritical ielement iof ipsychotherapeutic imanagement iis ithe ipresence iof ia itherapeutic
nurse-patient irelationship. iOne-on-one itime iwith inursing istaff iwill ihelp iin iestablishing
ithisiconnection. iWhile ithe iother ioptions iare iappropriate iand iclient icentered, ithe inurse-
client irelation iis icritical iin ithe i long-term idelivery iof iquality ieffective icare ito ithis iclient.
DIF: Cognitive ilevel: iApplying TOP: i Nursing iprocess:
iImplementationiMSC: i Client iNeeds: iPsychosocial iIntegrity
5. A ipatient‘s ihaloperidol idosage iwas ireduced i2 iweeks iago ito idecrease iside ieffects.
iWhat iassessment iquestion idemonstrates ithe inurse‘s iunderstanding iof ithe iresulting
ineeds iof itheiclient?
a. ―Will iyou ihave iany idifficulty igetting i your iprescription irefilled?‖
b. ―Have i you ibegun iexperiencing iany iforms iof ihallucinations?‖
c. ―What i do iyou iexpect i will ioccur isince ithe idosage ihas ibeen ireduced?‖
d. ―What i can iI ido ito i help iyou imanage ithis ireduction iin ihaloperidol
itherapy?‖
ANSWER: i B
It iwill ibe inecessary ifor ithe inurse ito iassess ifor iexacerbation iof ithe ipatient‘s isymptoms iof
ipsychosis ias iwell ias ifor ia ilessening iof iside ieffects. iDosage idecrease imight ilead ito ithe
ireturn ior iworsening iof ipositive isymptoms isuch ias ihallucinations iand idelusions, iand
inegative isymptoms isuch ias iblunted iaffect, isocial iwithdrawal, iand ipoor igrooming. iWhile
ithe iother ioptions imay ibe iappropriate iassessment iquestions, ithey iare inot idirected iat ithe
icurrent ineeds iofithe iclient; ithe iidentification iof iemerging ipsychotic ibehaviors.
DIF: Cognitive ilevel: iAnalyzing TOP: i Nursing iprocess:
iAssessmentiMSC: i Client iNeeds: iPhysiologic iIntegrity
