Test Bank for Keltner’s Psychiatric Nur
v v v v vv
sing, 9th Edition by Debbie Steele
v v v v v v
|Chapter 1-36 |All Chapters v v v v
Chapter 01: Me, Meds, Milieu
v v v v
Steele: Keltner’s Psychiatric Nursing, 9th Edition
v v v v v
MULTIPLEvCHOICE
1. Avnewlyvlicensedvnursevasksvavnursingvrecruitervforvavdescriptionvofvnursingvpracticevinvthevp
sychiatricvsetting.vWhatvisvthevnursevrecruiter‘svbestvresponse?
a. ―Thevnursevprimarilyvservesvinvavsupportivevrolevtovmembersvofvthevhealthvcarevdel
iveryvteam.‖
b. ―Thevmultidisciplinaryvapproachveliminatesvthevneedvtovclearlyvdefinevthevresponsi
bilitiesvofvnursingvinvsuchvavsetting.‖
c. ―Nursingvactionsvarevidentifiedvbyvthevinstitutionvthatvdistinguishesvnursingvfromvo
thervmentalvhealthvprofessions.‖
d. ―Nursingvoffersvuniquevcontributionsvtovthevpsychotherapeuticvmanagementvofvps
ychiatricvpatients.‖
ANS:v D
Professionalvrolevoverlapvcannotvbevdenied;vhowever,vnursingvisvuniquevinvitsvfocusvonvandvappl
icationvofvpsychotherapeuticvmanagement.vNeithervthevfacilityvnorvthevmultidisciplinaryvteamvd
efinevthevprofessionalvresponsibilitiesvofvitsvmembersvbutvrathervutilizesvtheirvuniquevskillsvtovpr
ovidevholisticvcare.vIdeally,vallvteamvmembersvsupportveachvothervandvhavevfunctionsvwithinvthe
vteam.
DIF: Cognitivevlevel:vAnalyzing
TOP:vNursingvprocess:vImplementationvMSC:vClientvNeeds:vSafe,vEffectivev
CarevEnvironment
2. Whichvcomponentvofvthevnursingvprocessvwillvthevnursevfocusvuponvtovaddressvthevr
esponsibilityvtovmatchvindividualvpatientvneedsvwithvappropriatevservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:v C
Propervassessmentvisvcriticalvforvbeingvablevtovdeterminevthevappropriatevlevelvofvservicesvthatvwi
llvprovidevoptimalvcarevwhilevconsideringvpatientvinputvandvatvthevlowestvcost.vPlanningvandvimpl
ementationvutilizesvthevassessmentvdatavtovidentifyvandvexecutevactionsv(treatmentvplan)vthatvwill
vprovidevappropriatevcare.vEvaluation vvalidatesvtheveffectiveness vofvthevtreatmentvplan.
DIF: Cognitivevlevel:vApplying
TOP:vNursingvprocess:vAssessmentvMSC:vClientvNeeds:vSafe,vEffectivev
CarevEnvironment
3. Anvadultvdiagnosedvwithvparanoidvschizophreniavfrequentlyvexperiencesvauditoryvhallucina
tionsvandvwalksvaboutvthevunit,vmuttering.vWhichvnursingvactionvdemonstratesvthevnurse‘svun
,derstandingvofveffectivevpsychotherapeuticvmanagementvofvthisvclient?
,a. Discussingvthevdiseasevprocessvofvschizophreniavwithvthevclientvandvtheirvdomesticvp
artner
b. Minimizingvcontactvbetweenvthisvpatientvandvothervpatientsvtovassurevavstress-
freevmilieu
c. AdministeringvPRNvmedicationvwhenvfirstvobservingvthevevidencevthatvthevclient
, mayvbevhallucinating
d. Independentlyvdeterminingvthatvbehaviorvmodificationvisvappropriatevtovdecreasevt
hevclient‘svparanoidvthoughts
ANS:vA
Anvunderstandingvofvpsychopathologyvisvthevfoundationvonvwhichvthevthreevcomponentsvofvpsy
chotherapeuticvmanagementvrest;vitvfacilitatesvtherapeuticvcommunicationvandvprovidesvavbasisv
forvunderstandingvpsychopharmacologyvandvmilieuvmanagement.vMinimizingvcontactvbetween
vthevpatient vandvothersvandvadministeringvPRNvmedicationvindiscriminatelyvarevnontherapeuticv
interventions.vUsingvbehaviorvmodificationvtovdecreasevthevfrequencyvofvhallucinationsvwouldv
needvtovbevincorporatedvintovthevplanvofvcarevbyvthevcarevteam.
DIF: Cognitivevlevel:vApplying
TOP:vNursingvprocess:vImplementationvMSC:vClientvNeeds:vSafe,vEffectivev
CarevEnvironment
4. Anvadultvdiagnosedvwithvchronicvdepressionvisvhospitalizedvaftervavsuicidevattempt.vWhichvi
nterventionvisvcriticalvinvassuringvlong-
term,veffectivevclientvcarevasvdescribedvbyvpsychotherapeuticvmanagement?
a. Involvementvinvgroupvtherapies
b. Focusvofvclosevsupervisionvbyvthevunitvstaff
c. Maintainingveffectivevcommunicationvwithvsupportvsystem
d. Frequentlyvscheduledvone-on-onevtimevwithvnursingvstaff
ANS:vD
Avcriticalvelementvofvpsychotherapeuticvmanagementvisvthevpresencevofvavtherapeutic
nurse-patientvrelationship.vOne-on-
onevtimevwithvnursingvstaffvwillvhelpvinvestablishingvthisvconnection.vWhilevthevothervoptionsvar
evappropriatevandvclientvcentered,vthevnurse-clientvrelationvisvcriticalvinvthevlong-
termvdeliveryvofvqualityveffectivevcarevtovthisvclient.
DIF: Cognitivevlevel:vApplying
TOP:vNursingvprocess:vImplementationvMSC:vClientvNeeds:vPsychosocialvInt
egrity
5. Avpatient‘svhaloperidolvdosagevwasvreducedv2vweeksvagovtovdecreasevsideveffects.vWhatvas
sessmentvquestionvdemonstratesvthevnurse‘svunderstandingvofvthevresultingvneedsvofvthevcli
ent?
a. ―Willvyouvhavevanyvdifficultyvgettingvyourvprescriptionvrefilled?‖
b. ―Havev youvbegunvexperiencingvanyvformsvofvhallucinations?‖
c. ―Whatvdovyouvexpectvwillvoccurvsincevthevdosagevhasvbeenvreduced?‖
d. ―WhatvcanvIvdovtovhelpvyouvmanagevthisvreductionvinvhaloperidolvtherapy?‖
ANS:vB
Itvwillvbevnecessaryvforvthevnursevtovassessvforvexacerbationvofvthevpatient‘svsymptomsvofvpsych
osisvasvwellvasvforvavlesseningvofvsideveffects.vDosagevdecreasevmightvleadvtovthevreturnvorvworse
ningvofvpositivevsymptomsvsuchvasvhallucinationsvandvdelusions,vandvnegativevsymptomsvsuchv
asvbluntedvaffect,vsocialvwithdrawal,vandvpoorvgrooming.vWhilevthevothervoptionsvmayvbevappro
priatevassessmentvquestions,vtheyvarevnotvdirectedvatvthevcurrentvneedsvofvthevclientvwhichvisvthevi
dentificationvofvemergingvpsychoticvbehaviors.
DIF: Cognitivevlevel:vAnalyzing
TOP:vNursingvprocess:vAssessmentvMSC:vClientvNeeds:vPhysiologicvInte
grity
v v v v vv
sing, 9th Edition by Debbie Steele
v v v v v v
|Chapter 1-36 |All Chapters v v v v
Chapter 01: Me, Meds, Milieu
v v v v
Steele: Keltner’s Psychiatric Nursing, 9th Edition
v v v v v
MULTIPLEvCHOICE
1. Avnewlyvlicensedvnursevasksvavnursingvrecruitervforvavdescriptionvofvnursingvpracticevinvthevp
sychiatricvsetting.vWhatvisvthevnursevrecruiter‘svbestvresponse?
a. ―Thevnursevprimarilyvservesvinvavsupportivevrolevtovmembersvofvthevhealthvcarevdel
iveryvteam.‖
b. ―Thevmultidisciplinaryvapproachveliminatesvthevneedvtovclearlyvdefinevthevresponsi
bilitiesvofvnursingvinvsuchvavsetting.‖
c. ―Nursingvactionsvarevidentifiedvbyvthevinstitutionvthatvdistinguishesvnursingvfromvo
thervmentalvhealthvprofessions.‖
d. ―Nursingvoffersvuniquevcontributionsvtovthevpsychotherapeuticvmanagementvofvps
ychiatricvpatients.‖
ANS:v D
Professionalvrolevoverlapvcannotvbevdenied;vhowever,vnursingvisvuniquevinvitsvfocusvonvandvappl
icationvofvpsychotherapeuticvmanagement.vNeithervthevfacilityvnorvthevmultidisciplinaryvteamvd
efinevthevprofessionalvresponsibilitiesvofvitsvmembersvbutvrathervutilizesvtheirvuniquevskillsvtovpr
ovidevholisticvcare.vIdeally,vallvteamvmembersvsupportveachvothervandvhavevfunctionsvwithinvthe
vteam.
DIF: Cognitivevlevel:vAnalyzing
TOP:vNursingvprocess:vImplementationvMSC:vClientvNeeds:vSafe,vEffectivev
CarevEnvironment
2. Whichvcomponentvofvthevnursingvprocessvwillvthevnursevfocusvuponvtovaddressvthevr
esponsibilityvtovmatchvindividualvpatientvneedsvwithvappropriatevservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:v C
Propervassessmentvisvcriticalvforvbeingvablevtovdeterminevthevappropriatevlevelvofvservicesvthatvwi
llvprovidevoptimalvcarevwhilevconsideringvpatientvinputvandvatvthevlowestvcost.vPlanningvandvimpl
ementationvutilizesvthevassessmentvdatavtovidentifyvandvexecutevactionsv(treatmentvplan)vthatvwill
vprovidevappropriatevcare.vEvaluation vvalidatesvtheveffectiveness vofvthevtreatmentvplan.
DIF: Cognitivevlevel:vApplying
TOP:vNursingvprocess:vAssessmentvMSC:vClientvNeeds:vSafe,vEffectivev
CarevEnvironment
3. Anvadultvdiagnosedvwithvparanoidvschizophreniavfrequentlyvexperiencesvauditoryvhallucina
tionsvandvwalksvaboutvthevunit,vmuttering.vWhichvnursingvactionvdemonstratesvthevnurse‘svun
,derstandingvofveffectivevpsychotherapeuticvmanagementvofvthisvclient?
,a. Discussingvthevdiseasevprocessvofvschizophreniavwithvthevclientvandvtheirvdomesticvp
artner
b. Minimizingvcontactvbetweenvthisvpatientvandvothervpatientsvtovassurevavstress-
freevmilieu
c. AdministeringvPRNvmedicationvwhenvfirstvobservingvthevevidencevthatvthevclient
, mayvbevhallucinating
d. Independentlyvdeterminingvthatvbehaviorvmodificationvisvappropriatevtovdecreasevt
hevclient‘svparanoidvthoughts
ANS:vA
Anvunderstandingvofvpsychopathologyvisvthevfoundationvonvwhichvthevthreevcomponentsvofvpsy
chotherapeuticvmanagementvrest;vitvfacilitatesvtherapeuticvcommunicationvandvprovidesvavbasisv
forvunderstandingvpsychopharmacologyvandvmilieuvmanagement.vMinimizingvcontactvbetween
vthevpatient vandvothersvandvadministeringvPRNvmedicationvindiscriminatelyvarevnontherapeuticv
interventions.vUsingvbehaviorvmodificationvtovdecreasevthevfrequencyvofvhallucinationsvwouldv
needvtovbevincorporatedvintovthevplanvofvcarevbyvthevcarevteam.
DIF: Cognitivevlevel:vApplying
TOP:vNursingvprocess:vImplementationvMSC:vClientvNeeds:vSafe,vEffectivev
CarevEnvironment
4. Anvadultvdiagnosedvwithvchronicvdepressionvisvhospitalizedvaftervavsuicidevattempt.vWhichvi
nterventionvisvcriticalvinvassuringvlong-
term,veffectivevclientvcarevasvdescribedvbyvpsychotherapeuticvmanagement?
a. Involvementvinvgroupvtherapies
b. Focusvofvclosevsupervisionvbyvthevunitvstaff
c. Maintainingveffectivevcommunicationvwithvsupportvsystem
d. Frequentlyvscheduledvone-on-onevtimevwithvnursingvstaff
ANS:vD
Avcriticalvelementvofvpsychotherapeuticvmanagementvisvthevpresencevofvavtherapeutic
nurse-patientvrelationship.vOne-on-
onevtimevwithvnursingvstaffvwillvhelpvinvestablishingvthisvconnection.vWhilevthevothervoptionsvar
evappropriatevandvclientvcentered,vthevnurse-clientvrelationvisvcriticalvinvthevlong-
termvdeliveryvofvqualityveffectivevcarevtovthisvclient.
DIF: Cognitivevlevel:vApplying
TOP:vNursingvprocess:vImplementationvMSC:vClientvNeeds:vPsychosocialvInt
egrity
5. Avpatient‘svhaloperidolvdosagevwasvreducedv2vweeksvagovtovdecreasevsideveffects.vWhatvas
sessmentvquestionvdemonstratesvthevnurse‘svunderstandingvofvthevresultingvneedsvofvthevcli
ent?
a. ―Willvyouvhavevanyvdifficultyvgettingvyourvprescriptionvrefilled?‖
b. ―Havev youvbegunvexperiencingvanyvformsvofvhallucinations?‖
c. ―Whatvdovyouvexpectvwillvoccurvsincevthevdosagevhasvbeenvreduced?‖
d. ―WhatvcanvIvdovtovhelpvyouvmanagevthisvreductionvinvhaloperidolvtherapy?‖
ANS:vB
Itvwillvbevnecessaryvforvthevnursevtovassessvforvexacerbationvofvthevpatient‘svsymptomsvofvpsych
osisvasvwellvasvforvavlesseningvofvsideveffects.vDosagevdecreasevmightvleadvtovthevreturnvorvworse
ningvofvpositivevsymptomsvsuchvasvhallucinationsvandvdelusions,vandvnegativevsymptomsvsuchv
asvbluntedvaffect,vsocialvwithdrawal,vandvpoorvgrooming.vWhilevthevothervoptionsvmayvbevappro
priatevassessmentvquestions,vtheyvarevnotvdirectedvatvthevcurrentvneedsvofvthevclientvwhichvisvthevi
dentificationvofvemergingvpsychoticvbehaviors.
DIF: Cognitivevlevel:vAnalyzing
TOP:vNursingvprocess:vAssessmentvMSC:vClientvNeeds:vPhysiologicvInte
grity
