TEST BANK - Keltners Psychiatric Nursing, 9th
c c c c c c
c Edition (Steele),
c c
Chapters 1 - 36 | All Chapters Complete
c c c c c c c c
,
,Chapter 01: Med, Meds, Milieu
c c c c
Keltner: Psychiatric Nursing, 8th Edition
c c c c
MULTIPLE CHOICE c
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
c c c c c c c c c c c c c c
psychiatric setting. What is the nurse recruiter‘s best response?
c c c c c c c c c
a. ―The nurse primarily serves in a supportive role to members of the health care
c c c c c c c c c c c c c
delivery team.‖ c
b. ―The multidisciplinary approach eliminates the need to clearly define the
c c c c c c c c c
responsibilities of nursing in such a setting.‖ c c c c c c
c. ―Nursing actions are identified by the institution that distinguishes nursing from
c c c c c c c c c c
other mental health professions.‖ c c c
d. ―Nursing offers unique contributions to the psychotherapeutic management of c c c c c c c c
psychiatric patients.‖ c
ANSWER: D c
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
c c c c c c c c c c c c c c
application ofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
c c c c c c c c c c c
define the professional responsibilities of its members but rather utilizes their unique skills to
c c c c c c c c c c c c c c
provide holistic care. Ideally, all team members support each other and have functions within the
c c c c c c c c c c c c c c c
team.
c
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation c c c c c
MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c
2. Which component of the nursing process will the nurse focus upon to address the
c c c c c c c c c c c c c
responsibility to match individual patient needs with appropriate services?
c c c c c c c c c
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C c
Proper assessment is critical for being able to determine the appropriate level of services that will
c c c c c c c c c c c c c c c
provide optimal care while considering patient input and at the lowest cost. Planning and
c c c c c c c c c c c c c c
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
c c c c c c c c c c c c c
will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
c c c c c c c c c c c c
DIF: Cognitive level: Applying TOP: Nursing process: Assessment c c c c c
MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinationsand
c c c c c c c c c c
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
c c c c c c c c c c c c c
effective psychotherapeutic management of this client?
c c c c c c
a. Discussing the disease process of schizophrenia with the client and their domestic c c c c c c c c c c c
partner
b. Minimizing contact between this patient and other patients to assure a stress free c c c c c c c c c c c c
milieu
c. Administering PRN medication when first observing the evidence that the client c c c c c c c c c c
, may be hallucinating c c
d. Independently determining that behavior modification is appropriate to decrease c c c c c c c c
the client‘s paranoid thoughts
c c c
ANSWER: A c
An understanding of psychopathology is the foundation on which the three components of
c c c c c c c c c c c c
psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
c c c c c c c c c c c
for understanding psychopharmacology and milieu management. Minimizing contact between the
c c c c c c c c c c
patient and others and administering PRN medication indiscriminately are nontherapeutic
c c c c c c c c c c
interventions. Using behavior modification to decrease the frequency of hallucinations would need
c c c c c c c c c c c c
to be incorporated into the plan of care by the care team.
c c c c c c c c c c c c
DIF: Cognitive level: Applying TOP: Nursing process: Implementation c c c c c
MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
c c c c c c c c c c c c
intervention is critical in assuring long-term, effective client care as described by
c c c c c c c c c c c c
psychotherapeutic management?
c c
a. Involvement in group therapies c c c
b. Focus of close supervision by the unit staff c c c c c c c
c. Maintaining effective communication with support system c c c c c
d. Frequently scheduled one-on-one time with nursing staff c c c c c c
ANSWER: D c
A critical element of psychotherapeutic management is the presence of a therapeutic
c c c c c c c c c c c
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this c c c c c c c c c c c
connection. While the other options are appropriate and client centered, the nurse-client relation
c c c c c c c c c c c c c
is critical in the long-term delivery of quality effective care to this client.
c c c c c c c c c c c c c
DIF: Cognitive level: Applying TOP: Nursing process: Implementation c c c c c
MSC: Client Needs: Psychosocial Integrity
c c c c c
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
c c c c c c c c c c c c c
assessment question demonstrates the nurse‘s understanding ofthe resulting needs of the
c c c c c c c c c c c c
client?
c
a. ―Will you have any difficulty getting your prescription refilled?‖
c c c c c c c c
b. ―Have you begun experiencing any forms of hallucinations?‖ c c c c c c c
c. ―What do you expect will occur since the dosage has been reduced?‖c c c c c c c c c c c
d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
c c c c c c c c c c c c
ANSWER: B c
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
c c c c c c c c c c c c c c c c
as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
c c c c c c c c c c c c c c c c c c c
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
c c c c c c c c c c c c c
affect, social withdrawal, and poor grooming. While the other options may be appropriate
c c c c c c c c c c c c c
assessment questions, they are not directed at the current needs ofthe client; the identification of
c c c c c c c c c c c c c c c c
emerging psychotic behaviors.
c c c
DIF: Cognitive level: Analyzing c c TOP: Nursing process: Assessment c c c
MSC: Client Needs: Physiologic Integrity
c c c c c
c c c c c c
c Edition (Steele),
c c
Chapters 1 - 36 | All Chapters Complete
c c c c c c c c
,
,Chapter 01: Med, Meds, Milieu
c c c c
Keltner: Psychiatric Nursing, 8th Edition
c c c c
MULTIPLE CHOICE c
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
c c c c c c c c c c c c c c
psychiatric setting. What is the nurse recruiter‘s best response?
c c c c c c c c c
a. ―The nurse primarily serves in a supportive role to members of the health care
c c c c c c c c c c c c c
delivery team.‖ c
b. ―The multidisciplinary approach eliminates the need to clearly define the
c c c c c c c c c
responsibilities of nursing in such a setting.‖ c c c c c c
c. ―Nursing actions are identified by the institution that distinguishes nursing from
c c c c c c c c c c
other mental health professions.‖ c c c
d. ―Nursing offers unique contributions to the psychotherapeutic management of c c c c c c c c
psychiatric patients.‖ c
ANSWER: D c
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
c c c c c c c c c c c c c c
application ofpsychotherapeutic management. Neither the facility nor the multidisciplinaryteam
c c c c c c c c c c c
define the professional responsibilities of its members but rather utilizes their unique skills to
c c c c c c c c c c c c c c
provide holistic care. Ideally, all team members support each other and have functions within the
c c c c c c c c c c c c c c c
team.
c
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation c c c c c
MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c
2. Which component of the nursing process will the nurse focus upon to address the
c c c c c c c c c c c c c
responsibility to match individual patient needs with appropriate services?
c c c c c c c c c
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C c
Proper assessment is critical for being able to determine the appropriate level of services that will
c c c c c c c c c c c c c c c
provide optimal care while considering patient input and at the lowest cost. Planning and
c c c c c c c c c c c c c c
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
c c c c c c c c c c c c c
will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
c c c c c c c c c c c c
DIF: Cognitive level: Applying TOP: Nursing process: Assessment c c c c c
MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinationsand
c c c c c c c c c c
walks about the unit, muttering. Which nursing action demonstrates the nurse‘s understanding of
c c c c c c c c c c c c c
effective psychotherapeutic management of this client?
c c c c c c
a. Discussing the disease process of schizophrenia with the client and their domestic c c c c c c c c c c c
partner
b. Minimizing contact between this patient and other patients to assure a stress free c c c c c c c c c c c c
milieu
c. Administering PRN medication when first observing the evidence that the client c c c c c c c c c c
, may be hallucinating c c
d. Independently determining that behavior modification is appropriate to decrease c c c c c c c c
the client‘s paranoid thoughts
c c c
ANSWER: A c
An understanding of psychopathology is the foundation on which the three components of
c c c c c c c c c c c c
psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
c c c c c c c c c c c
for understanding psychopharmacology and milieu management. Minimizing contact between the
c c c c c c c c c c
patient and others and administering PRN medication indiscriminately are nontherapeutic
c c c c c c c c c c
interventions. Using behavior modification to decrease the frequency of hallucinations would need
c c c c c c c c c c c c
to be incorporated into the plan of care by the care team.
c c c c c c c c c c c c
DIF: Cognitive level: Applying TOP: Nursing process: Implementation c c c c c
MSC: Client Needs: Safe, Effective Care Environment
c c c c c c c
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
c c c c c c c c c c c c
intervention is critical in assuring long-term, effective client care as described by
c c c c c c c c c c c c
psychotherapeutic management?
c c
a. Involvement in group therapies c c c
b. Focus of close supervision by the unit staff c c c c c c c
c. Maintaining effective communication with support system c c c c c
d. Frequently scheduled one-on-one time with nursing staff c c c c c c
ANSWER: D c
A critical element of psychotherapeutic management is the presence of a therapeutic
c c c c c c c c c c c
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this c c c c c c c c c c c
connection. While the other options are appropriate and client centered, the nurse-client relation
c c c c c c c c c c c c c
is critical in the long-term delivery of quality effective care to this client.
c c c c c c c c c c c c c
DIF: Cognitive level: Applying TOP: Nursing process: Implementation c c c c c
MSC: Client Needs: Psychosocial Integrity
c c c c c
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
c c c c c c c c c c c c c
assessment question demonstrates the nurse‘s understanding ofthe resulting needs of the
c c c c c c c c c c c c
client?
c
a. ―Will you have any difficulty getting your prescription refilled?‖
c c c c c c c c
b. ―Have you begun experiencing any forms of hallucinations?‖ c c c c c c c
c. ―What do you expect will occur since the dosage has been reduced?‖c c c c c c c c c c c
d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
c c c c c c c c c c c c
ANSWER: B c
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of psychosis
c c c c c c c c c c c c c c c c
as well as for a lessening of side effects. Dosage decrease might lead to the return or worsening of
c c c c c c c c c c c c c c c c c c c
positive symptoms such as hallucinations and delusions, and negative symptoms such as blunted
c c c c c c c c c c c c c
affect, social withdrawal, and poor grooming. While the other options may be appropriate
c c c c c c c c c c c c c
assessment questions, they are not directed at the current needs ofthe client; the identification of
c c c c c c c c c c c c c c c c
emerging psychotic behaviors.
c c c
DIF: Cognitive level: Analyzing c c TOP: Nursing process: Assessment c c c
MSC: Client Needs: Physiologic Integrity
c c c c c
