Keltner’s Psychiatric Nursing, 9th Edition (Steele) – Test Bank | Complete Coverage of Chapters 1–36

TEST BANK - Keltners Psychiatric Nursing,
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete

,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8thEdition
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MULTIPLE CHOICE br




1. A newlylicensed asks a nursing recruiter for a description ofnursing practice inthepsychi
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atric setting. What is the nurse recruiter‘s best response?
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a. ―The nurse primarily serves in a supportive role to members ofthe health care
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delivery team.‖ br




b. ―The multidisciplinary approach eliminates the need to clearlydefine thebr br br br br br br r
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responsibilities ofnursing in such a setting.‖ br br br br br br




c. ―Nursing actions are identified by the institution that distinguishes nursing from br br br br br br br br br br




other mental health professions.‖ br br br




d. ―Nursing offers unique contributions to the psychotherapeutic management of br br br br br br br br




psychiatric patients.‖ b r




ANSWER: D b r




Professional role overlap cannot be denied; however, nursing is unique in its focus on and applicatio br br br br br br br br br br br br br br br




nofpsychotherapeutic management. Neitherthe facility northe multidisciplinaryteam define the pr
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ofessional responsibilities of its members but rather utilizes their unique skills to provide holistic ca
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re. Ideally, all team members support each other and have functions within the team.
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DIF: Cognitive level: Analyzing br br




TOP: Nursing process: ImplementationMSC: Client Needs: Safe, Effective Car b r br br r
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e Environment
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2. Which component ofthe nursing process willthe nurse focus upon to address therespo
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nsibilityto match individualpatient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C b r




Proper assessment is critical for being able to determine the appropriate level of services that will pro
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vide optimal care while considering patient input and at the lowest cost. Planning and implementatio
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n utilizes the assessment data to identify and execute actions (treatment plan) that willprovide appro
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priate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
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DIF: Cognitive level: Applying br br




TOP: Nursing process: AssessmentMSC: Client Needs: Safe, Effective Car b r br br r
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e Environment
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3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
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walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding ofe
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ffective psychotherapeutic management ofthis client? br br br br br




a. Discussing the disease process ofschizophrenia withthe client and their domestic br br br br r
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partner
b. Minimizing contact betweenthis patient and other patients to assure a stress free br br br br br br br br br br br br




milieu
c. Administering PRN medicationwhen first observing the evidence that the client br br br br br br br br br br

, maybe hallucinating br br




d. Independentlydetermining that behavior modification is appropriateto decrease br br br br br br br br




the client‘s paranoid thoughts br br br




ANSWER: A b r




An understanding of psychopathology is the foundation on which the three components of psychother
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apeutic management rest; it facilitatestherapeutic communicationand providesabasis for understand
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ing psychopharmacology and milieu management. Minimizing contact between the patient and other
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s and administering PRN medication indiscriminately are nontherapeutic interventions. Using behav
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ior modification to decrease the frequency of hallucinations would need to be incorporated into the pla
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nofcare bythe care team.
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DIF: Cognitive level: Applying br br




TOP: Nursing process: ImplementationMSC: Client Needs: Safe, Effective Car b r br br r
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e Environment
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4. Anadult diagnosed withchronic depression is hospitalized after a suicide attempt. Whichinterv
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ention is critical in assuring long- br br br br br




term, effective client care as described by psychotherapeutic management?
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a. Involvement ingrouptherapies br br br




b. Focus ofclose supervision by the unit staff br br br br br br br




c. Maintaining effective communicationwithsupport system br br br br br




d. Frequentlyscheduled one-on-one time withnursing staff br br br br br br




ANSWER: D b r




Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
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nurse-patient relationship. One-on- br br




one time withnursing staffwillhelp inestablishing thisconnection. While the other options are appr
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opriate and client centered, the nurse-client relation is critical in the long- br br br br br br br br br br br




termdeliveryofqualityeffective care to this client. br br br br br br br br




DIF: Cognitive level: Applying br br




TOP: Nursing process: ImplementationMSC: Client Needs: Psychosocial Integ
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rity

5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What assess
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ment questiondemonstratesthe nurse‘sunderstanding ofthe resulting needs oftheclient?
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a. ―Will you have any difficultygetting your prescription refilled?‖ br br br br br br br br




b. ―Have you begun experiencing any forms of hallucinations?‖ br br br br br br br




c. ―What do you expect willoccur since the dosage has been reduced?‖ br br br br br br br br br br br




d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ br br br br br br br br br br br r
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ANSWER: B b r




It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
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well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of positi
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ve symptoms such as hallucinations and delusions, and negative symptoms such as blunted affect, s
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ocial withdrawal, and poor grooming. While the other options maybe appropriate assessment quest
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ions, theyare not directed at the current needs ofthe client; the identification ofemerging psychotic b
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ehaviors.

DIF: Cognitive level: Analyzing br br




TOP: Nursing process: AssessmentMSC: Client Needs: Physiologic Integr
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ity