, PsychiatrichNursingh8thhEditionhKeltnerhTesthBank
Chapter 01: Med, Meds, Milieu
h h h h
Keltner: Psychiatric Nursing, 8th Edition
h h h h
MULTIPLEhCHOICE
1. Ahnewlyhlicensedhaskshahnursinghrecruiterhforhahdescriptionhofhnursinghpracticehinhthehp
sychiatrichsetting.hWhathishthehnursehrecruiter’shbesthresponse?
a. “Thehnursehprimarilyhserveshinhahsupportivehrolehtohmembershofhthehhealthhcarehd
eliveryhteam.”
b. “Thehmultidisciplinaryhapproachheliminateshthehneedhtohclearlyhdefinehthehr
esponsibilitieshofhnursinghinhsuchhahsetting.”
c. “Nursinghactionsharehidentifiedhbyhthehinstitutionhthathdistinguisheshnursinghfromho
therhmentalhhealthhprofessions.”
d. “Nursinghoffershuniquehcontributionshtohthehpsychotherapeutichmanagementhofh
psychiatrichpatients.”
ANS:h D
Professionalhrolehoverlaphcannothbehdenied;hhowever,hnursinghishuniquehinhitshfocushonhandhap
plicationhofhpsychotherapeutichmanagement.hNeitherhthehfacilityhnorhthehmultidisciplinaryhtea
mhdefinehthehprofessionalhresponsibilitieshofhitshmembershbuthratherhutilizeshtheirhuniquehskill
shtohprovidehholistichcare.hIdeally,hallhteamhmembershsupportheachhotherhandhhavehfunctionshw
ithinhthehteam.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hImplementationhMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
2. Whichhcomponenthofhthehnursin
N R I G B.C M
Ug pSroceNsshw
Till theOnursehfocushuponhtohaddresshthehr
esponsibilityhtohmatchhindividualhpatienthneedshwithhappropriatehservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:h C
Properhassessmenthishcriticalhforhbeinghablehtohdeterminehthehappropriatehlevelhofhserviceshthathw
illhprovidehoptimalhcarehwhilehconsideringhpatienthinputhandhaththehlowesthcost.hPlanninghandhim
plementationhutilizeshthehassessmenthdatahtohidentifyhandhexecutehactionsh(treatmenthplan)hthath
willhprovidehappropriatehcare.hEvaluationhvalidateshtheheffectivenesshofhthehtreatmenthplan.
DIF: Cognitivehlevel:hApplying
TOP:h Nursinghprocess:hAssessmenthMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
3. Anhadulthdiagnosedhwithhparanoidhschizophreniahfrequenthexperienceshauditoryhhallucinationsh
andhwalkshabouththehunit,hmuttering.hWhichhnursinghactionhdemonstrateshthehnurse’shunderstan
dinghofheffectivehpsychotherapeutichmanagementhofhthishclient?
a. Discussinghthehdiseasehprocesshofhschizophreniahwithhthehclienthandhtheirhdomestich
partner
b. Minimizinghcontacthbetweenhthishpatienthandhotherhpatientshtohassurehahstresshfreeh
milieu
c. AdministeringhPRNhmedicationhwhenhfirsthobservinghthehevidencehthaththehclient
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mayhbehhallucinating
d. Independentlyhdetermininghthathbehaviorhmodificationhishappropriatehtohdecreaseht
hehclient’shparanoidhthoughts
ANS:h A
Anhunderstandinghofhpsychopathologyhishthehfoundationhonhwhichhthehthreehcomponentshofhps
ychotherapeutichmanagementhrest;hithfacilitateshtherapeutichcommunicationhandhprovideshahbas
ishforhunderstandinghpsychopharmacologyhandhmilieuhmanagement.hMinimizinghcontacthbet
weenhthehpatienthandhothershandhadministeringhPRNhmedicationhindiscriminatelyharehnonthera
peutichinterventions.hUsinghbehaviorhmodificationhtohdecreasehthehfrequencyhofhhallucination
shwouldhneedhtohbehincorporatedhintohthehplanhofhcarehbyhthehcarehteam.
DIF: Cognitivehlevel:hApplying
TOP:h Nursinghprocess:hImplementationhMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
4. Anhadulthdiagnosedhwithhchronichdepressionhishhospitalizedhafterhahsuicidehattempt.hWhichhi
nterventionhishcriticalhinhassuringhlong-
term,heffectivehclienthcarehashdescribedhbyhpsychotherapeutichmanagement?
a. Involvementhinhgrouphtherapies
b. Focushofhclosehsupervisionhbyhthehunithstaff
c. Maintainingheffectivehcommunicationhwithhsupporthsystem
d. Frequentlyhscheduledhone-on-onehtimehwithhnursinghstaff
ANS:h D
Ahcriticalhelementhofhpsychotherapeutichmanagementhishthehpresencehofhahtherapeutic
nurse-patienthrelationship.hOne-on-
onehtimehwithhnursinghstaffhwillhhelphinhestablishinghthishconnection.hWhilehthehotherhoptionsh
arehappropriatehandhclienthcentered,hthehnurse-clienthrelationhishcriticalhinhthehlongN
-
RSdeIliNveGrT
teUrm yhB
of.qC
uaOliM
tyheffectivehcarehtohthishclient.
DIF: Cognitivehlevel:hApplying
TOP:h Nursinghprocess:hImplementationhMSC:h ClienthNeeds:hPsychosocialhInt
egrity
5. Ahpatient’shhaloperidolhdosagehwashreducedh2hweekshagohtohdecreasehsideheffects.hWhathas
sessmenthquestionhdemonstrateshthehnurse’shunderstandinghofhthehresultinghneedshofhthehcli
ent?
a. “Willhyouhhavehanyhdifficultyhgettinghyourhprescriptionhrefilled?”
b. “Havehyouhbegunhexperiencinghanyhformshofhhallucinations?”
c. “Whathdohyouhexpecthwillhoccurhsincehthehdosagehhashbeenhreduced?”
d. “WhathcanhIhdohtohhelphyouhmanagehthishreductionhinhhaloperidolhtherapy?”
ANS:h B
Ithwillhbehnecessaryhforhthehnursehtohassesshforhexacerbationhofhthehpatient’shsymptomshofhpsych
osishashwellhashforhahlesseninghofhsideheffects.hDosagehdecreasehmighthleadhtohthehreturnhorhworse
ninghofhpositivehsymptomshsuchhashhallucinationshandhdelusions,handhnegativehsymptomshsuchh
ashbluntedhaffect,hsocialhwithdrawal,handhpoorhgrooming.hWhilehthehotherhoptionshmayhbehappro
priatehassessmenthquestions,htheyharehnothdirectedhaththehcurrenthneedshofhthehclient;hthehidentific
ationhofhemerginghpsychotichbehaviors.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hAssessmenthMSC:h ClienthNeeds:hPhysiologichInte
grity
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6. Whichhstatementhformshthehfoundationhuponhwhichhahnursehshouldhbasehthehimplementationhofhp
sychotherapeutichmanagementhtohthehcarehofhahpatienthwithhmentalhillness?
a. Thehnurse’shrolehinhclienthcarehishsupportedhbyhthehmultidisciplinaryhteam.
b. Omittinghanyhonehcomponenthwillhcompromisehtheheffectivenesshofhthehtreatment.
c. Thehmosthimportanthelementhofhpsychotherapeutichmanagementhishdrughtherapy.
d. Ahtherapeutichnurse-patienthrelationshiphishthehmosthimportanthaspecthofhtreatment.
ANS:h B
Whenhonehelementhishmissing,htreatmenthishusuallyhcompromised.hNohsinglehelementhishmorehi
mportanththanhthehothers;hhowever,hpatients’hneedshgovernhthehapplicationhofhthehcomponentsha
ndhpermithjudicioushuse.hThehremaininghoptionshidentifyhcomponentshofhthehpsychotherapeutich
managementhprocess.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hAnalysishMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
7. Whichhstatementhmosthaccuratelyhdescribeshahnurse’shrolehregardinghpsychopharmacology?
a. “YouhwillhneedhtohfrequentlyhmakehdecisionshregardinghthehadministrationhofhPRNh
medicationshtohhelphthehclienthmanagehanger.”
b. “It’shahnursinghresponsibilityhtohadjusthahmedicationhdosehtohassureheffectivehpatienthr
esponses.”
c. “Nurseshadministershmedicationshwhilehevaluatinghdrugheffectivenesshishahmedicalhr
esponsibility.”
d. “Tohbesthassurehappropriatehresponse,hahpatient’shquestionshabouthdrughtherapyhs
houldhbehreferredhtohthehpsychiatrist.”
ANS:h A
NursinghassessmenthandhanalN ysUisRoS
fhdIaN
taGmTigBh.
thsCuO
ggMesththehneedhforhPRNhmedicationhashpatien
thanxietyhincreaseshorhpsychotichsymptomshbecomehmorehacute.hThehnursehishthehhealth
teamhmemberhwhohmakeshthishdetermination.hNursesharehresponsiblehforhmonitoringhdrugheffect
ivenesshashwellhashadministeringhmedication.hNurseshshouldhassumehresponsibilityhforhteachingh
patientshabouththehsideheffectshofhmedications.hNurseshcannothalterhprescribedhdosageshofhmedica
tionshunlesshtheyhhavehprescriptivehprivileges.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hAnalysishMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
8. Whenhconsideringhenvironmentalhaspectshofhmilieuhmanagement,hwhichhinterventionhhashtheh
highesthpriorityhforhahclienthadmittedhafterhahfailedhsuicidehattempt?
a. Sendinghthehclient’shnewhmedicationhprescriptionshtohthehpharmacy
b. Assigninghahstaffhmemberhtohone-on-onehobservationhofhthehclient
c. Orientinghthehclienthtohthehmilieu’shpublichandhprivatehspaces
d. Havinghallhpotentiallyhdangeroushitemshremovedhfromhthehclient’shbelongings
ANS:h B
Milieuhmanagementhprovideshahproactivehapproachhtohcare.hSafetyhoverrideshallhotherhdimensi
onshofhthehmilieu.hInitiationhofhsuicidehprecautionsharehthehpriorityhforhthishclient.hAllhthehremai
ninghoptionsharehappropriatehbuthnonehprotecththehclienthfromhthehriskhofhanotherhattempthtohsel
f-harmhasheffectivelyhashone-on-onehobservationhashparthofhsuicidehprecautions.
DIF: Cognitivehlevel:hAnalyzing TOP:h Nursinghprocess:hImplementation
NURSINGTB.COM
Chapter 01: Med, Meds, Milieu
h h h h
Keltner: Psychiatric Nursing, 8th Edition
h h h h
MULTIPLEhCHOICE
1. Ahnewlyhlicensedhaskshahnursinghrecruiterhforhahdescriptionhofhnursinghpracticehinhthehp
sychiatrichsetting.hWhathishthehnursehrecruiter’shbesthresponse?
a. “Thehnursehprimarilyhserveshinhahsupportivehrolehtohmembershofhthehhealthhcarehd
eliveryhteam.”
b. “Thehmultidisciplinaryhapproachheliminateshthehneedhtohclearlyhdefinehthehr
esponsibilitieshofhnursinghinhsuchhahsetting.”
c. “Nursinghactionsharehidentifiedhbyhthehinstitutionhthathdistinguisheshnursinghfromho
therhmentalhhealthhprofessions.”
d. “Nursinghoffershuniquehcontributionshtohthehpsychotherapeutichmanagementhofh
psychiatrichpatients.”
ANS:h D
Professionalhrolehoverlaphcannothbehdenied;hhowever,hnursinghishuniquehinhitshfocushonhandhap
plicationhofhpsychotherapeutichmanagement.hNeitherhthehfacilityhnorhthehmultidisciplinaryhtea
mhdefinehthehprofessionalhresponsibilitieshofhitshmembershbuthratherhutilizeshtheirhuniquehskill
shtohprovidehholistichcare.hIdeally,hallhteamhmembershsupportheachhotherhandhhavehfunctionshw
ithinhthehteam.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hImplementationhMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
2. Whichhcomponenthofhthehnursin
N R I G B.C M
Ug pSroceNsshw
Till theOnursehfocushuponhtohaddresshthehr
esponsibilityhtohmatchhindividualhpatienthneedshwithhappropriatehservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:h C
Properhassessmenthishcriticalhforhbeinghablehtohdeterminehthehappropriatehlevelhofhserviceshthathw
illhprovidehoptimalhcarehwhilehconsideringhpatienthinputhandhaththehlowesthcost.hPlanninghandhim
plementationhutilizeshthehassessmenthdatahtohidentifyhandhexecutehactionsh(treatmenthplan)hthath
willhprovidehappropriatehcare.hEvaluationhvalidateshtheheffectivenesshofhthehtreatmenthplan.
DIF: Cognitivehlevel:hApplying
TOP:h Nursinghprocess:hAssessmenthMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
3. Anhadulthdiagnosedhwithhparanoidhschizophreniahfrequenthexperienceshauditoryhhallucinationsh
andhwalkshabouththehunit,hmuttering.hWhichhnursinghactionhdemonstrateshthehnurse’shunderstan
dinghofheffectivehpsychotherapeutichmanagementhofhthishclient?
a. Discussinghthehdiseasehprocesshofhschizophreniahwithhthehclienthandhtheirhdomestich
partner
b. Minimizinghcontacthbetweenhthishpatienthandhotherhpatientshtohassurehahstresshfreeh
milieu
c. AdministeringhPRNhmedicationhwhenhfirsthobservinghthehevidencehthaththehclient
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mayhbehhallucinating
d. Independentlyhdetermininghthathbehaviorhmodificationhishappropriatehtohdecreaseht
hehclient’shparanoidhthoughts
ANS:h A
Anhunderstandinghofhpsychopathologyhishthehfoundationhonhwhichhthehthreehcomponentshofhps
ychotherapeutichmanagementhrest;hithfacilitateshtherapeutichcommunicationhandhprovideshahbas
ishforhunderstandinghpsychopharmacologyhandhmilieuhmanagement.hMinimizinghcontacthbet
weenhthehpatienthandhothershandhadministeringhPRNhmedicationhindiscriminatelyharehnonthera
peutichinterventions.hUsinghbehaviorhmodificationhtohdecreasehthehfrequencyhofhhallucination
shwouldhneedhtohbehincorporatedhintohthehplanhofhcarehbyhthehcarehteam.
DIF: Cognitivehlevel:hApplying
TOP:h Nursinghprocess:hImplementationhMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
4. Anhadulthdiagnosedhwithhchronichdepressionhishhospitalizedhafterhahsuicidehattempt.hWhichhi
nterventionhishcriticalhinhassuringhlong-
term,heffectivehclienthcarehashdescribedhbyhpsychotherapeutichmanagement?
a. Involvementhinhgrouphtherapies
b. Focushofhclosehsupervisionhbyhthehunithstaff
c. Maintainingheffectivehcommunicationhwithhsupporthsystem
d. Frequentlyhscheduledhone-on-onehtimehwithhnursinghstaff
ANS:h D
Ahcriticalhelementhofhpsychotherapeutichmanagementhishthehpresencehofhahtherapeutic
nurse-patienthrelationship.hOne-on-
onehtimehwithhnursinghstaffhwillhhelphinhestablishinghthishconnection.hWhilehthehotherhoptionsh
arehappropriatehandhclienthcentered,hthehnurse-clienthrelationhishcriticalhinhthehlongN
-
RSdeIliNveGrT
teUrm yhB
of.qC
uaOliM
tyheffectivehcarehtohthishclient.
DIF: Cognitivehlevel:hApplying
TOP:h Nursinghprocess:hImplementationhMSC:h ClienthNeeds:hPsychosocialhInt
egrity
5. Ahpatient’shhaloperidolhdosagehwashreducedh2hweekshagohtohdecreasehsideheffects.hWhathas
sessmenthquestionhdemonstrateshthehnurse’shunderstandinghofhthehresultinghneedshofhthehcli
ent?
a. “Willhyouhhavehanyhdifficultyhgettinghyourhprescriptionhrefilled?”
b. “Havehyouhbegunhexperiencinghanyhformshofhhallucinations?”
c. “Whathdohyouhexpecthwillhoccurhsincehthehdosagehhashbeenhreduced?”
d. “WhathcanhIhdohtohhelphyouhmanagehthishreductionhinhhaloperidolhtherapy?”
ANS:h B
Ithwillhbehnecessaryhforhthehnursehtohassesshforhexacerbationhofhthehpatient’shsymptomshofhpsych
osishashwellhashforhahlesseninghofhsideheffects.hDosagehdecreasehmighthleadhtohthehreturnhorhworse
ninghofhpositivehsymptomshsuchhashhallucinationshandhdelusions,handhnegativehsymptomshsuchh
ashbluntedhaffect,hsocialhwithdrawal,handhpoorhgrooming.hWhilehthehotherhoptionshmayhbehappro
priatehassessmenthquestions,htheyharehnothdirectedhaththehcurrenthneedshofhthehclient;hthehidentific
ationhofhemerginghpsychotichbehaviors.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hAssessmenthMSC:h ClienthNeeds:hPhysiologichInte
grity
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6. Whichhstatementhformshthehfoundationhuponhwhichhahnursehshouldhbasehthehimplementationhofhp
sychotherapeutichmanagementhtohthehcarehofhahpatienthwithhmentalhillness?
a. Thehnurse’shrolehinhclienthcarehishsupportedhbyhthehmultidisciplinaryhteam.
b. Omittinghanyhonehcomponenthwillhcompromisehtheheffectivenesshofhthehtreatment.
c. Thehmosthimportanthelementhofhpsychotherapeutichmanagementhishdrughtherapy.
d. Ahtherapeutichnurse-patienthrelationshiphishthehmosthimportanthaspecthofhtreatment.
ANS:h B
Whenhonehelementhishmissing,htreatmenthishusuallyhcompromised.hNohsinglehelementhishmorehi
mportanththanhthehothers;hhowever,hpatients’hneedshgovernhthehapplicationhofhthehcomponentsha
ndhpermithjudicioushuse.hThehremaininghoptionshidentifyhcomponentshofhthehpsychotherapeutich
managementhprocess.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hAnalysishMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
7. Whichhstatementhmosthaccuratelyhdescribeshahnurse’shrolehregardinghpsychopharmacology?
a. “YouhwillhneedhtohfrequentlyhmakehdecisionshregardinghthehadministrationhofhPRNh
medicationshtohhelphthehclienthmanagehanger.”
b. “It’shahnursinghresponsibilityhtohadjusthahmedicationhdosehtohassureheffectivehpatienthr
esponses.”
c. “Nurseshadministershmedicationshwhilehevaluatinghdrugheffectivenesshishahmedicalhr
esponsibility.”
d. “Tohbesthassurehappropriatehresponse,hahpatient’shquestionshabouthdrughtherapyhs
houldhbehreferredhtohthehpsychiatrist.”
ANS:h A
NursinghassessmenthandhanalN ysUisRoS
fhdIaN
taGmTigBh.
thsCuO
ggMesththehneedhforhPRNhmedicationhashpatien
thanxietyhincreaseshorhpsychotichsymptomshbecomehmorehacute.hThehnursehishthehhealth
teamhmemberhwhohmakeshthishdetermination.hNursesharehresponsiblehforhmonitoringhdrugheffect
ivenesshashwellhashadministeringhmedication.hNurseshshouldhassumehresponsibilityhforhteachingh
patientshabouththehsideheffectshofhmedications.hNurseshcannothalterhprescribedhdosageshofhmedica
tionshunlesshtheyhhavehprescriptivehprivileges.
DIF: Cognitivehlevel:hAnalyzing
TOP:h Nursinghprocess:hAnalysishMSC:h ClienthNeeds:hSafe,hEffectiveh
CarehEnvironment
8. Whenhconsideringhenvironmentalhaspectshofhmilieuhmanagement,hwhichhinterventionhhashtheh
highesthpriorityhforhahclienthadmittedhafterhahfailedhsuicidehattempt?
a. Sendinghthehclient’shnewhmedicationhprescriptionshtohthehpharmacy
b. Assigninghahstaffhmemberhtohone-on-onehobservationhofhthehclient
c. Orientinghthehclienthtohthehmilieu’shpublichandhprivatehspaces
d. Havinghallhpotentiallyhdangeroushitemshremovedhfromhthehclient’shbelongings
ANS:h B
Milieuhmanagementhprovideshahproactivehapproachhtohcare.hSafetyhoverrideshallhotherhdimensi
onshofhthehmilieu.hInitiationhofhsuicidehprecautionsharehthehpriorityhforhthishclient.hAllhthehremai
ninghoptionsharehappropriatehbuthnonehprotecththehclienthfromhthehriskhofhanotherhattempthtohsel
f-harmhasheffectivelyhashone-on-onehobservationhashparthofhsuicidehprecautions.
DIF: Cognitivehlevel:hAnalyzing TOP:h Nursinghprocess:hImplementation
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