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, Psychiatric Nursing 8th Edition Keltner Test Bank
i
i
i
El
El
El
E
El
Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
ite
t
t
t
t
st
ul
ul
ul
ul
MULTIPLE CHOICE
u
va
va
va
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
dy
psychiatric setting. What is the nurse recruiter’s best response?
dy
dy
dy
a. “The nurse primarily serves in a supportive role to members of the health care
va
delivery team.”
b. “The multidisciplinary approach eliminates the need to clearly define the
u
u
u
u
responsibilities of nursing in such a setting.”
st
st
st
lt
c. “Nursing actions are identified by the institution that distinguishes nursing from
ite
ite
ite
other mental health professions.”
d. “Nursing offers unique contributions to the psychotherapeutic management of
psychiatric patients.”
El
El
El
E
ANS: 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
t
lt
lt
lt
skills to provide holistic care. Ideally, all team members support each other and have
ul
au
au
au
functions within the team.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
yv
yv
yv
MSC: Client Needs: Safe, Effective Care Environment
N R I G B.C M
ud
ud
ud
U process
2. Which component of the nursing S N will
T theOnurse focus upon to address the
responsibility to match individual patient needs with appropriate services?
st
st
st
a. Planning
b. Evaluation
ite
ite
ite
c. Assessment
d. Implementation
El
El
El
E
ANS: 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.
t
lt
lt
lt
ul
au
au
au
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
yv
yv
yv
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
and walks about the unit, muttering. Which nursing action demonstrates the nurse’s
ud
ud
ud
understanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their domestic
st
st
st
partner
b. Minimizing contact between this patient and other patients to assure a stress free
ite
ite
ite
milieu
c. Administering PRN medication when first observing the evidence that the client
El
El
El
E
NURSINGTB.COM
, Psychiatric Nursing 8th Edition Keltner Test Bank
i
i
i
El
El
El
E
El
may be hallucinating
d. Independently determining that behavior modification is appropriate to decrease
ite
the client’s paranoid thoughts
t
t
t
t
st
ul
ul
ul
ul
ANS: A
An understanding of psychopathology is the foundation on which the three components of
u
va
va
va
psychotherapeutic management rest; it facilitates therapeutic communication and provides a
dy
basis for understanding psychopharmacology and milieu management. Minimizing contact
between the patient and others and administering PRN medication indiscriminately are
dy
dy
dyva
nontherapeutic interventions. Using behavior modification to decrease the frequency of
hallucinations would need to be incorporated into the plan of care by the care team.
u
u
u
u
st
st
st
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
lt
MSC: Client Needs: Safe, Effective Care Environment
ite
ite
ite
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
El
El
El
intervention is critical in assuring long-term, effective client care as described by
E
psychotherapeutic management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining effective communication with support system
t
lt
lt
lt
d. Frequently scheduled one-on-one time with nursing staff
ul
au
au
au
ANS: D
A critical element of psychotherapeutic management is the presence of a therapeutic
yv
yv
yv
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this
connection. While the other options are appropriate and client centered, the nurse-client
NURSdelivery
INGTB.C OM effective care to this client.
ud
ud
ud
relation is critical in the long-term of quality
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
st
st
st
MSC: Client Needs: Psychosocial Integrity
ite
ite
ite
5. A patient’s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
assessment question demonstrates the nurse’s understanding of the resulting needs of the
El
El
El
client?
E
a. “Will you have any difficulty getting your prescription refilled?”
b. “Have you begun experiencing any forms of hallucinations?”
c. “What do you expect will occur since the dosage has been reduced?”
d. “What can I do to help you manage this reduction in haloperidol therapy?”
t
lt
lt
lt
ul
ANS: B
au
au
au
It will be necessary for the nurse to assess for exacerbation of the patient’s symptoms of
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return
yv
yv
yv
or worsening of positive symptoms such as hallucinations and delusions, and negative
symptoms such as blunted affect, social withdrawal, and poor grooming. While the other
ud
ud
ud
options may be appropriate assessment questions, they are not directed at the current needs of
the client; the identification of emerging psychotic behaviors.
st
st
st
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity
ite
ite
ite
El
El
El
E
NURSINGTB.COM
ite ite ite
st st st
ud ud u dy
yv yv va
au au ul
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ite ite ite
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ite El
ite ite ite st
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lit ite ite
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ud
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lt El lt El l t
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ud
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ite
lit ite ite
es st st
st
u
tu
d ud ud
dy
va
yv yv u yv
au au lt au
lt E lt E l t
, Psychiatric Nursing 8th Edition Keltner Test Bank
i
i
i
El
El
El
E
El
Chapter 01: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 8th Edition
ite
t
t
t
t
st
ul
ul
ul
ul
MULTIPLE CHOICE
u
va
va
va
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
dy
psychiatric setting. What is the nurse recruiter’s best response?
dy
dy
dy
a. “The nurse primarily serves in a supportive role to members of the health care
va
delivery team.”
b. “The multidisciplinary approach eliminates the need to clearly define the
u
u
u
u
responsibilities of nursing in such a setting.”
st
st
st
lt
c. “Nursing actions are identified by the institution that distinguishes nursing from
ite
ite
ite
other mental health professions.”
d. “Nursing offers unique contributions to the psychotherapeutic management of
psychiatric patients.”
El
El
El
E
ANS: 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
t
lt
lt
lt
skills to provide holistic care. Ideally, all team members support each other and have
ul
au
au
au
functions within the team.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
yv
yv
yv
MSC: Client Needs: Safe, Effective Care Environment
N R I G B.C M
ud
ud
ud
U process
2. Which component of the nursing S N will
T theOnurse focus upon to address the
responsibility to match individual patient needs with appropriate services?
st
st
st
a. Planning
b. Evaluation
ite
ite
ite
c. Assessment
d. Implementation
El
El
El
E
ANS: 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.
t
lt
lt
lt
ul
au
au
au
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Safe, Effective Care Environment
yv
yv
yv
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
and walks about the unit, muttering. Which nursing action demonstrates the nurse’s
ud
ud
ud
understanding of effective psychotherapeutic management of this client?
a. Discussing the disease process of schizophrenia with the client and their domestic
st
st
st
partner
b. Minimizing contact between this patient and other patients to assure a stress free
ite
ite
ite
milieu
c. Administering PRN medication when first observing the evidence that the client
El
El
El
E
NURSINGTB.COM
, Psychiatric Nursing 8th Edition Keltner Test Bank
i
i
i
El
El
El
E
El
may be hallucinating
d. Independently determining that behavior modification is appropriate to decrease
ite
the client’s paranoid thoughts
t
t
t
t
st
ul
ul
ul
ul
ANS: A
An understanding of psychopathology is the foundation on which the three components of
u
va
va
va
psychotherapeutic management rest; it facilitates therapeutic communication and provides a
dy
basis for understanding psychopharmacology and milieu management. Minimizing contact
between the patient and others and administering PRN medication indiscriminately are
dy
dy
dyva
nontherapeutic interventions. Using behavior modification to decrease the frequency of
hallucinations would need to be incorporated into the plan of care by the care team.
u
u
u
u
st
st
st
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
lt
MSC: Client Needs: Safe, Effective Care Environment
ite
ite
ite
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
El
El
El
intervention is critical in assuring long-term, effective client care as described by
E
psychotherapeutic management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining effective communication with support system
t
lt
lt
lt
d. Frequently scheduled one-on-one time with nursing staff
ul
au
au
au
ANS: D
A critical element of psychotherapeutic management is the presence of a therapeutic
yv
yv
yv
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this
connection. While the other options are appropriate and client centered, the nurse-client
NURSdelivery
INGTB.C OM effective care to this client.
ud
ud
ud
relation is critical in the long-term of quality
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
st
st
st
MSC: Client Needs: Psychosocial Integrity
ite
ite
ite
5. A patient’s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
assessment question demonstrates the nurse’s understanding of the resulting needs of the
El
El
El
client?
E
a. “Will you have any difficulty getting your prescription refilled?”
b. “Have you begun experiencing any forms of hallucinations?”
c. “What do you expect will occur since the dosage has been reduced?”
d. “What can I do to help you manage this reduction in haloperidol therapy?”
t
lt
lt
lt
ul
ANS: B
au
au
au
It will be necessary for the nurse to assess for exacerbation of the patient’s symptoms of
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return
yv
yv
yv
or worsening of positive symptoms such as hallucinations and delusions, and negative
symptoms such as blunted affect, social withdrawal, and poor grooming. While the other
ud
ud
ud
options may be appropriate assessment questions, they are not directed at the current needs of
the client; the identification of emerging psychotic behaviors.
st
st
st
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity
ite
ite
ite
El
El
El
E
NURSINGTB.COM
