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