TESTBANK -KeltnersPsychiatricNursing,9th
n n n n n n
n Edition (Steele), n n
Chapters1 -36|AllChaptersComplete
n n n n n n n n
,
,Chapter 01: Med, Meds, Milieu
n n n n
Keltner: Psychiatric Nursing, 8thEdition
n n n n
MULTIPLE CHOICE n
1. A newlylicensed asks a nursing recruiter for a descriptionofnursing practice inthe
n n n n n n n n n n n n n n
psychiatric setting. What is the nurse recruiter‘s best response?
n n n n n n n n n
a. ―The nurse primarily serves in a supportive role to members ofthe health care
n n n n n n n n n n n n n
delivery team.‖ n
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
n n n n n n n n n
responsibilities ofnursing in such a setting.‖ n n n n n n
c. ―Nursing actions are identified by the institution that distinguishes nursing from
n n n n n n n n n n
other mental health professions.‖ n n n
d. ―Nursing offers unique contributions to the psychotherapeutic management of n n n n n n n n
psychiatric patients.‖ n
ANSWER: D n
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
n n n n n n n n n n n n n n
applicationofpsychotherapeutic management. Neitherthefacility northe multidisciplinaryteam
n n n n n n n n n n n
define the professional responsibilities of its members but rather utilizes their unique skills to
n n n n n n n n n n n n n n
provide holistic care. Ideally, all team members support each other and have functions within the
n n n n n n n n n n n n n n n
team.
n
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation n n n n n
MSC: Client Needs: Safe, EffectiveCareEnvironment
n n n n n n n
2. Whichcomponent ofthe nursing process willthe nurse focus uponto address the
n n n n n n n n n n n n n
responsibilityto match individualpatient needs withappropriate services?
n n n n n n n n n
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C n
Proper assessment is critical for being able to determine the appropriate level of services that will
n n n n n n n n n n n n n n n
provide optimal care while considering patient input and at the lowest cost. Planning and
n n n n n n n n n n n n n n
implementation utilizes the assessment data to identify and execute actions (treatment plan) that will
n n n n n n n n n n n n n n
provide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
n n n n n n n n n n n
DIF: Cognitive level: Applying TOP: Nursingprocess: Assessment n n n n n
MSC: Client Needs: Safe, EffectiveCareEnvironment
n n n n n n n
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
n n n n n n n n n n
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
n n n n n n n n n n n n n
effective psychotherapeutic management ofthis client?
n n n n n n
a. Discussing the disease process ofschizophrenia withthe client and their domestic n n n n n n n n n n n
partner
b. Minimizing contact betweenthispatient and other patients to assure a stress free n n n n n n n n n n n n
milieu
c. Administering PRN medicationwhen first observing the evidencethat the client n n n n n n n n n n
, maybehallucinating n n
d. Independentlydetermining that behavior modification isappropriateto decrease n n n n n n n n
the client‘s paranoid thoughts
n n n
ANSWER: A n
An understanding of psychopathology is the foundation on which the three components of
n n n n n n n n n n n n
psychotherapeutic management rest; it facilitatestherapeuticcommunicationand providesabasis for
n n n n n n n n n n n n
understanding psychopharmacology and milieu management. Minimizing contact between the
n n n n n n n n n
patient and others and administering PRN medication indiscriminately are nontherapeutic
n n n n n n n n n n
interventions. Using behavior modification to decrease the frequency of hallucinations would need to
n n n n n n n n n n n n n
be incorporatedinto the planofcare by the care team.
n n n n n n n n n n n
DIF: Cognitive level: Applying TOP: Nursing process: Implementation n n n n n
MSC: Client Needs: Safe, EffectiveCareEnvironment
n n n n n n n
4. Anadult diagnosed withchronic depression is hospitalized after a suicide attempt.Which
n n n n n n n n n n n n
intervention is critical in assuring long-term, effective client care as described by
n n n n n n n n n n n n
psychotherapeutic management?
n n
a. Involvement ingrouptherapies n n n
b. Focus ofclose supervision bythe unit staff n n n n n n n
c. Maintaining effective communicationwithsupport system n n n n n
d. Frequentlyscheduled one-on-one time withnursing staff n n n n n n
ANSWER: D n
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
n n n n n n n n n n n
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this n n n n n n n n n n n
connection. While the other options are appropriate and client centered, the nurse-client relation is
n n n n n n n n n n n n n n
criticalin the long-termdeliveryofqualityeffective care to this client.
n n n n n n n n n n n n
DIF: Cognitive level: Applying TOP: Nursing process: Implementation n n n n n
MSC: Client Needs: Psychosocial Integrity
n n n n n
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
n n n n n n n n n n n n n
assessment questiondemonstratesthe nurse‘sunderstanding ofthe resulting needsofthe
n n n n n n n n n n n n
client?
n
a. ―Will you have any difficultygetting your prescription refilled?‖
n n n n n n n n
b. ―Have you begun experiencing any forms of hallucinations?‖ n n n n n n n
c. ―What do you expect willoccur since the dosage has been reduced?‖ n n n n n n n n n n n
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ n n n n n n n n n n n n
ANSWER: B n
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
n n n n n n n n n n n n n n n n n
well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
n n n n n n n n n n n n n n n n n n
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
n n n n n n n n n n n n n
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
n n n n n n n n n n n n n
assessment questions,theyare not directed at the current needsofthe client;the identificationof
n n n n n n n n n n n n n n n n
emerging psychotic behaviors.
n n n
DIF: Cognitive level: Analyzing n n TOP: Nursingprocess: Assessment n n n
MSC: Client Needs: Physiologic Integrity
n n n n n
n n n n n n
n Edition (Steele), n n
Chapters1 -36|AllChaptersComplete
n n n n n n n n
,
,Chapter 01: Med, Meds, Milieu
n n n n
Keltner: Psychiatric Nursing, 8thEdition
n n n n
MULTIPLE CHOICE n
1. A newlylicensed asks a nursing recruiter for a descriptionofnursing practice inthe
n n n n n n n n n n n n n n
psychiatric setting. What is the nurse recruiter‘s best response?
n n n n n n n n n
a. ―The nurse primarily serves in a supportive role to members ofthe health care
n n n n n n n n n n n n n
delivery team.‖ n
b. ―The multidisciplinary approach eliminates the need to clearlydefine the
n n n n n n n n n
responsibilities ofnursing in such a setting.‖ n n n n n n
c. ―Nursing actions are identified by the institution that distinguishes nursing from
n n n n n n n n n n
other mental health professions.‖ n n n
d. ―Nursing offers unique contributions to the psychotherapeutic management of n n n n n n n n
psychiatric patients.‖ n
ANSWER: D n
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
n n n n n n n n n n n n n n
applicationofpsychotherapeutic management. Neitherthefacility northe multidisciplinaryteam
n n n n n n n n n n n
define the professional responsibilities of its members but rather utilizes their unique skills to
n n n n n n n n n n n n n n
provide holistic care. Ideally, all team members support each other and have functions within the
n n n n n n n n n n n n n n n
team.
n
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation n n n n n
MSC: Client Needs: Safe, EffectiveCareEnvironment
n n n n n n n
2. Whichcomponent ofthe nursing process willthe nurse focus uponto address the
n n n n n n n n n n n n n
responsibilityto match individualpatient needs withappropriate services?
n n n n n n n n n
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C n
Proper assessment is critical for being able to determine the appropriate level of services that will
n n n n n n n n n n n n n n n
provide optimal care while considering patient input and at the lowest cost. Planning and
n n n n n n n n n n n n n n
implementation utilizes the assessment data to identify and execute actions (treatment plan) that will
n n n n n n n n n n n n n n
provide appropriate care. Evaluationvalidatesthe effectiveness ofthe treatment plan.
n n n n n n n n n n n
DIF: Cognitive level: Applying TOP: Nursingprocess: Assessment n n n n n
MSC: Client Needs: Safe, EffectiveCareEnvironment
n n n n n n n
3. Anadult diagnosed withparanoid schizophrenia frequent experiences auditoryhallucinationsand
n n n n n n n n n n
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
n n n n n n n n n n n n n
effective psychotherapeutic management ofthis client?
n n n n n n
a. Discussing the disease process ofschizophrenia withthe client and their domestic n n n n n n n n n n n
partner
b. Minimizing contact betweenthispatient and other patients to assure a stress free n n n n n n n n n n n n
milieu
c. Administering PRN medicationwhen first observing the evidencethat the client n n n n n n n n n n
, maybehallucinating n n
d. Independentlydetermining that behavior modification isappropriateto decrease n n n n n n n n
the client‘s paranoid thoughts
n n n
ANSWER: A n
An understanding of psychopathology is the foundation on which the three components of
n n n n n n n n n n n n
psychotherapeutic management rest; it facilitatestherapeuticcommunicationand providesabasis for
n n n n n n n n n n n n
understanding psychopharmacology and milieu management. Minimizing contact between the
n n n n n n n n n
patient and others and administering PRN medication indiscriminately are nontherapeutic
n n n n n n n n n n
interventions. Using behavior modification to decrease the frequency of hallucinations would need to
n n n n n n n n n n n n n
be incorporatedinto the planofcare by the care team.
n n n n n n n n n n n
DIF: Cognitive level: Applying TOP: Nursing process: Implementation n n n n n
MSC: Client Needs: Safe, EffectiveCareEnvironment
n n n n n n n
4. Anadult diagnosed withchronic depression is hospitalized after a suicide attempt.Which
n n n n n n n n n n n n
intervention is critical in assuring long-term, effective client care as described by
n n n n n n n n n n n n
psychotherapeutic management?
n n
a. Involvement ingrouptherapies n n n
b. Focus ofclose supervision bythe unit staff n n n n n n n
c. Maintaining effective communicationwithsupport system n n n n n
d. Frequentlyscheduled one-on-one time withnursing staff n n n n n n
ANSWER: D n
Acriticalelement ofpsychotherapeutic management is the presence ofa therapeutic
n n n n n n n n n n n
nurse-patient relationship. One-on-one time withnursing staffwillhelp inestablishing this n n n n n n n n n n n
connection. While the other options are appropriate and client centered, the nurse-client relation is
n n n n n n n n n n n n n n
criticalin the long-termdeliveryofqualityeffective care to this client.
n n n n n n n n n n n n
DIF: Cognitive level: Applying TOP: Nursing process: Implementation n n n n n
MSC: Client Needs: Psychosocial Integrity
n n n n n
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
n n n n n n n n n n n n n
assessment questiondemonstratesthe nurse‘sunderstanding ofthe resulting needsofthe
n n n n n n n n n n n n
client?
n
a. ―Will you have any difficultygetting your prescription refilled?‖
n n n n n n n n
b. ―Have you begun experiencing any forms of hallucinations?‖ n n n n n n n
c. ―What do you expect willoccur since the dosage has been reduced?‖ n n n n n n n n n n n
d. ―What can I do to help you manage this reduction in haloperidoltherapy?‖ n n n n n n n n n n n n
ANSWER: B n
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis as
n n n n n n n n n n n n n n n n n
well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
n n n n n n n n n n n n n n n n n n
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
n n n n n n n n n n n n n
affect, social withdrawal, and poor grooming. While the other options maybe appropriate
n n n n n n n n n n n n n
assessment questions,theyare not directed at the current needsofthe client;the identificationof
n n n n n n n n n n n n n n n n
emerging psychotic behaviors.
n n n
DIF: Cognitive level: Analyzing n n TOP: Nursingprocess: Assessment n n n
MSC: Client Needs: Physiologic Integrity
n n n n n
