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Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Editi on
MULTIPLE CHOICE
A newly licensed nurse asks a nursing recruiter for a descripti on of nursing practi ce in the
psychiatric setti ng. What is the nurse recruiter‘s best response?
a. ―The nurse primarily serves in a supporti ve role to members of the health
care
delivery team.‖
b. ―The multi disciplinary approach eliminates the need to clearly defi ne the
responsibiliti es of nursing in such a setti ng.‖
c. ―Nursing acti ons are identi fi ed by the insti tuti on that disti nguishes
nursing from
other mental health professions.‖
d. ―Nursing off ers unique contributi ons to the psychotherapeuti c
management of
psychiatric pati ents.‖
ANS: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
applicati on of psychotherapeuti c management. Neither the facility nor the multi disciplinary
team defi ne the professional responsibiliti es of its members but rather uti lizes their unique
skills to provide holisti c care. Ideally, all team members support each other and have
functi ons within the team.
,DIF: Cogniti ve level: Analyzing TOP: Nursing process: Implementati on MSC: Client Needs:
Safe, Eff ecti ve Care Environment
Which component of the nursing process will the nurse focus upon to address the
responsibility to match individual pati ent needs with appropriate services?
a. Planning
b. Evaluati on
c. Assessment
d. Implementati on
ANS: C
Proper assessment is criti cal for being able to determine the appropriate level of services that
will provide opti mal care while considering pati ent input and at the lowest cost. Planning and
implementati on uti lizes the assessment data to identi fy and execute acti ons (treatment plan)
that will provide appropriate care. Evaluati on validates the eff ecti veness of the treatment
plan.
DIF: Cogniti ve level: Applying TOP: Nursing process: Assessment MSC: Client Needs: Safe,
Eff ecti ve Care Environment
An adult diagnosed with paranoid schizophrenia frequently experiences auditory
hallucinati ons and walks about the unit, mutt ering. Which nursing acti on demonstrates the
nurse‘s understanding of eff ecti ve psychotherapeuti c management of this client?
a. Discussing the disease process of schizophrenia with the client and their
domesti c
partner
b. Minimizing contact between this pati ent and other pati ents to assure a
stress-free
milieu
c. Administering PRN medicati on when fi rst observing the evidence that the
client
, may be hallucinati ng
d. Independently determining that behavior modifi cati on is appropriate to
decrease
the client‘s paranoid thoughts
ANS: A
An understanding of psychopathology is the foundati on on which the three components of
psychotherapeuti c management rest; it facilitates therapeuti c communicati on and provides a
basis for understanding psychopharmacology and milieu management. Minimizing contact
between the pati ent and others and administering PRN medicati on indiscriminately are
nontherapeuti c interventi ons. Using behavior modifi cati on to decrease the frequency of
hallucinati ons would need to be incorporated into the plan of care by the care team.
DIF: Cogniti ve level: Applying TOP: Nursing process: Implementati on MSC: Client Needs:
Safe, Eff ecti ve Care Environment
An adult diagnosed with chronic depression is hospitalized aft er a suicide att empt. Which
interventi on is criti cal in assuring long-term, eff ecti ve client care as described by
psychotherapeuti c management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining eff ecti ve communicati on with support
system
d. Frequently scheduled one-on-one ti me with nursing
staff
ANS: D
A criti cal element of psychotherapeuti c management is the presence of a therapeuti c
nurse-pati ent relati onship. One-on-one ti me with nursing staff will help in establishing this
connecti on. While the other opti ons are appropriate and client centered, the nurse-client
relati on is criti cal in the long-term delivery of quality eff ecti ve care to this client.
DIF: Cogniti ve level: Applying TOP: Nursing process: Implementati on MSC: Client Needs:
Psychosocial Integrity
A pati ent‘s haloperidol dosage was reduced 2 weeks ago to decrease side eff ects. What
assessment questi on demonstrates the nurse‘s understanding of the resulti ng needs of the
client?
a. ―Will you have any diffi culty getti ng your prescripti on refi lled?‖
b. ―Have you begun experiencing any forms of hallucinati ons?‖
c. ―What do you expect will occur since the dosage has been reduced?‖
, d. ―What can I do to help you manage this reducti on in haloperidol
therapy?‖
ANS: B
It will be necessary for the nurse to assess for exacerbati on of the pati ent‘s symptoms of
psychosis as well as for a lessening of side eff ects. Dosage decrease might lead to the return
or worsening of positi ve symptoms such as hallucinati ons and delusions, and negati ve
symptoms such as blunted aff ect, social withdrawal, and poor grooming. While the other
opti ons may be appropriate assessment questi ons, they are not directed at the current needs
of the client which is the identi fi cati on of emerging psychoti c behaviors.
DIF: Cogniti ve level: Analyzing TOP: Nursing process: Assessment MSC: Client Needs:
Physiologic Integrity
To Clarify, This Is A Test Bank, Not A Textbook You Have Immediate
Access To Download Your Test Bank.
No Delays In Loading Is Fast And Instant Immediately Aft er Purchase! You Will
Receive A Full Bank Of Tests, In Other Words, All Chapters Will Be There.
Test Banks Are Presented In PDF Format Therefore, No Special Soft ware
Is Required To Download Them
Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Editi on
MULTIPLE CHOICE
A newly licensed nurse asks a nursing recruiter for a descripti on of nursing practi ce in the
psychiatric setti ng. What is the nurse recruiter‘s best response?
a. ―The nurse primarily serves in a supporti ve role to members of the health
care
delivery team.‖
b. ―The multi disciplinary approach eliminates the need to clearly defi ne the
responsibiliti es of nursing in such a setti ng.‖
c. ―Nursing acti ons are identi fi ed by the insti tuti on that disti nguishes
nursing from
other mental health professions.‖
d. ―Nursing off ers unique contributi ons to the psychotherapeuti c
management of
psychiatric pati ents.‖
ANS: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
applicati on of psychotherapeuti c management. Neither the facility nor the multi disciplinary
team defi ne the professional responsibiliti es of its members but rather uti lizes their unique
skills to provide holisti c care. Ideally, all team members support each other and have
functi ons within the team.
,DIF: Cogniti ve level: Analyzing TOP: Nursing process: Implementati on MSC: Client Needs:
Safe, Eff ecti ve Care Environment
Which component of the nursing process will the nurse focus upon to address the
responsibility to match individual pati ent needs with appropriate services?
a. Planning
b. Evaluati on
c. Assessment
d. Implementati on
ANS: C
Proper assessment is criti cal for being able to determine the appropriate level of services that
will provide opti mal care while considering pati ent input and at the lowest cost. Planning and
implementati on uti lizes the assessment data to identi fy and execute acti ons (treatment plan)
that will provide appropriate care. Evaluati on validates the eff ecti veness of the treatment
plan.
DIF: Cogniti ve level: Applying TOP: Nursing process: Assessment MSC: Client Needs: Safe,
Eff ecti ve Care Environment
An adult diagnosed with paranoid schizophrenia frequently experiences auditory
hallucinati ons and walks about the unit, mutt ering. Which nursing acti on demonstrates the
nurse‘s understanding of eff ecti ve psychotherapeuti c management of this client?
a. Discussing the disease process of schizophrenia with the client and their
domesti c
partner
b. Minimizing contact between this pati ent and other pati ents to assure a
stress-free
milieu
c. Administering PRN medicati on when fi rst observing the evidence that the
client
, may be hallucinati ng
d. Independently determining that behavior modifi cati on is appropriate to
decrease
the client‘s paranoid thoughts
ANS: A
An understanding of psychopathology is the foundati on on which the three components of
psychotherapeuti c management rest; it facilitates therapeuti c communicati on and provides a
basis for understanding psychopharmacology and milieu management. Minimizing contact
between the pati ent and others and administering PRN medicati on indiscriminately are
nontherapeuti c interventi ons. Using behavior modifi cati on to decrease the frequency of
hallucinati ons would need to be incorporated into the plan of care by the care team.
DIF: Cogniti ve level: Applying TOP: Nursing process: Implementati on MSC: Client Needs:
Safe, Eff ecti ve Care Environment
An adult diagnosed with chronic depression is hospitalized aft er a suicide att empt. Which
interventi on is criti cal in assuring long-term, eff ecti ve client care as described by
psychotherapeuti c management?
a. Involvement in group therapies
b. Focus of close supervision by the unit staff
c. Maintaining eff ecti ve communicati on with support
system
d. Frequently scheduled one-on-one ti me with nursing
staff
ANS: D
A criti cal element of psychotherapeuti c management is the presence of a therapeuti c
nurse-pati ent relati onship. One-on-one ti me with nursing staff will help in establishing this
connecti on. While the other opti ons are appropriate and client centered, the nurse-client
relati on is criti cal in the long-term delivery of quality eff ecti ve care to this client.
DIF: Cogniti ve level: Applying TOP: Nursing process: Implementati on MSC: Client Needs:
Psychosocial Integrity
A pati ent‘s haloperidol dosage was reduced 2 weeks ago to decrease side eff ects. What
assessment questi on demonstrates the nurse‘s understanding of the resulti ng needs of the
client?
a. ―Will you have any diffi culty getti ng your prescripti on refi lled?‖
b. ―Have you begun experiencing any forms of hallucinati ons?‖
c. ―What do you expect will occur since the dosage has been reduced?‖
, d. ―What can I do to help you manage this reducti on in haloperidol
therapy?‖
ANS: B
It will be necessary for the nurse to assess for exacerbati on of the pati ent‘s symptoms of
psychosis as well as for a lessening of side eff ects. Dosage decrease might lead to the return
or worsening of positi ve symptoms such as hallucinati ons and delusions, and negati ve
symptoms such as blunted aff ect, social withdrawal, and poor grooming. While the other
opti ons may be appropriate assessment questi ons, they are not directed at the current needs
of the client which is the identi fi cati on of emerging psychoti c behaviors.
DIF: Cogniti ve level: Analyzing TOP: Nursing process: Assessment MSC: Client Needs:
Physiologic Integrity
