, PsychiatricyNursingy8thyEditionyKeltneryTestyBank
Chapter 01: Med, Meds, Milieu
y y y y
Keltner: Psychiatric Nursing, 8th Edition
y y y y
MULTIPLEyCHOICE
1. Aynewlyylicensedyasksyaynursingyrecruiteryforyaydescriptionyofynursingypracticeyinytheyp
sychiatricysetting.yWhatyisytheynurseyrecruiter’sybestyresponse?
a. “Theynurseyprimarilyyservesyinyaysupportiveyroleytoymembersyofytheyhealthycareyd
eliveryyteam.”
b. “Theymultidisciplinaryyapproachyeliminatesytheyneedytoyclearlyydefineytheyr
esponsibilitiesyofynursingyinysuchyaysetting.”
c. “Nursingyactionsyareyidentifiedybyytheyinstitutionythatydistinguishesynursingyfromy
otherymentalyhealthyprofessions.”
d. “Nursingyoffersyuniqueycontributionsytoytheypsychotherapeuticymanagementyofy
psychiatricypatients.”
ANS:y D
Professionalyroleyoverlapycannotybeydenied;yhowever,ynursingyisyuniqueyinyitsyfocusyonyandyappl
icationyofypsychotherapeuticymanagement.yNeitherytheyfacilityynorytheymultidisciplinaryyteamyd
efineytheyprofessionalyresponsibilitiesyofyitsymembersybutyratheryutilizesytheiryuniqueyskillsytoypr
ovideyholisticycare.yIdeally,yallyteamymembersysupportyeachyotheryandyhaveyfunctionsywithinyth
eyteam.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yImplementationyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
N R I G B.C M
Ug pSroceNssywTill theOnurseyfocusyuponytoyaddressytheyr
2. Whichycomponentyofytheynursin
esponsibilityytoymatchyindividualypatientyneedsywithyappropriateyservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:y C
Properyassessmentyisycriticalyforybeingyableytoydetermineytheyappropriateylevelyofyservicesythatywi
llyprovideyoptimalycareywhileyconsideringypatientyinputyandyatytheylowestycost.yPlanningyandyimp
lementationyutilizesytheyassessmentydataytoyidentifyyandyexecuteyactionsy(treatmentyplan)ythatywil
lyprovideyappropriateycare.yEvaluationyvalidatesytheyeffectivenessyofytheytreatmentyplan.
DIF: Cognitiveylevel:yApplying
TOP:y Nursingyprocess:yAssessmentyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
3. Anyadultydiagnosedywithyparanoidyschizophreniayfrequentyexperiencesyauditoryyhallucinationsy
andywalksyaboutytheyunit,ymuttering.yWhichynursingyactionydemonstratesytheynurse’syunderstan
dingyofyeffectiveypsychotherapeuticymanagementyofythisyclient?
a. Discussingytheydiseaseyprocessyofyschizophreniaywithytheyclientyandytheirydomesticy
partner
b. Minimizingycontactybetweenythisypatientyandyotherypatientsytoyassureyaystressyfreey
milieu
c. AdministeringyPRNymedicationywhenyfirstyobservingytheyevidenceythatytheyclient
NURSINGTB.COM
, PsychiatricyNursingy8thyEditionyKeltneryTestyBank
mayybeyhallucinating
d. Independentlyydeterminingythatybehaviorymodificationyisyappropriateytoydecreaseyt
heyclient’syparanoidythoughts
ANS:y A
Anyunderstandingyofypsychopathologyyisytheyfoundationyonywhichytheythreeycomponentsyofypsych
otherapeuticymanagementyrest;yityfacilitatesytherapeuticycommunicationyandyprovidesyaybasisyforyu
nderstandingypsychopharmacologyyandymilieuymanagement.yMinimizingycontactybetweenytheypa
tientyandyothersyandyadministeringyPRNymedicationyindiscriminatelyyareynontherapeuticyinterven
tions.yUsingybehaviorymodificationytoydecreaseytheyfrequencyyofyhallucinationsywouldyneedytoybey
incorporatedyintoytheyplanyofycareybyytheycareyteam.
DIF: Cognitiveylevel:yApplying
TOP:y Nursingyprocess:yImplementationyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
4. Anyadultydiagnosedywithychronicydepressionyisyhospitalizedyafteryaysuicideyattempt.yWhichyi
nterventionyisycriticalyinyassuringylong-
term,yeffectiveyclientycareyasydescribedybyypsychotherapeuticymanagement?
a. Involvementyinygroupytherapies
b. Focusyofycloseysupervisionybyytheyunitystaff
c. Maintainingyeffectiveycommunicationywithysupportysystem
d. Frequentlyyscheduledyone-on-oneytimeywithynursingystaff
ANS:y D
Aycriticalyelementyofypsychotherapeuticymanagementyisytheypresenceyofyaytherapeutic
nurse-patientyrelationship.yOne-on-
oneytimeywithynursingystaffywillyhelpyinyestablishingythisyconnection.yWhileytheyotheryoptionsyar
eyappropriateyandyclientycentered,ytheynurse-clientyrelationyisycriticalyinytheyl o n g N
-
RSdeIliNveGrT
teUrm yyB
of.qC
uaOliM
tyyeffectiveycareytoythisyclient.
DIF: Cognitiveylevel:yApplying
TOP:y Nursingyprocess:yImplementationyMSC:y ClientyNeeds:yPsychosocialyIn
tegrity
5. Aypatient’syhaloperidolydosageywasyreducedy2yweeksyagoytoydecreaseysideyeffects.yWhatyas
sessmentyquestionydemonstratesytheynurse’syunderstandingyofytheyresultingyneedsyofytheycli
ent?
a. “Willyyouyhaveyanyydifficultyygettingyyouryprescriptionyrefilled?”
b. “Haveyyouybegunyexperiencingyanyyformsyofyhallucinations?”
c. “Whatydoyyouyexpectywillyoccurysinceytheydosageyhasybeenyreduced?”
d. “WhatycanyIydoytoyhelpyyouymanageythisyreductionyinyhaloperidolytherapy?”
ANS:y B
Itywillybeynecessaryyforytheynurseytoyassessyforyexacerbationyofytheypatient’sysymptomsyofypsych
osisyasywellyasyforyaylesseningyofysideyeffects.yDosageydecreaseymightyleadytoytheyreturnyoryworse
ningyofypositiveysymptomsysuchyasyhallucinationsyandydelusions,yandynegativeysymptomsysuchy
asybluntedyaffect,ysocialywithdrawal,yandypoorygrooming.yWhileytheyotheryoptionsymayybeyappro
priateyassessmentyquestions,ytheyyareynotydirectedyatytheycurrentyneedsyofytheyclient;ytheyidentific
ationyofyemergingypsychoticybehaviors.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yAssessmentyMSC:y ClientyNeeds:yPhysiologicyInt
egrity
NURSINGTB.COM
, PsychiatricyNursingy8thyEditionyKeltneryTestyBank
6. Whichystatementyformsytheyfoundationyuponywhichyaynurseyshouldybaseytheyimplementationyofyp
sychotherapeuticymanagementytoytheycareyofyaypatientywithymentalyillness?
a. Theynurse’syroleyinyclientycareyisysupportedybyytheymultidisciplinaryyteam.
b. Omittingyanyyoneycomponentywillycompromiseytheyeffectivenessyofytheytreatment.
c. Theymostyimportantyelementyofypsychotherapeuticymanagementyisydrugytherapy.
d. Aytherapeuticynurse-patientyrelationshipyisytheymostyimportantyaspectyofytreatment.
ANS:y B
Whenyoneyelementyisymissing,ytreatmentyisyusuallyycompromised.yNoysingleyelementyisymoreyi
mportantythanytheyothers;yhowever,ypatients’yneedsygovernytheyapplicationyofytheycomponentsya
ndypermityjudiciousyuse.yTheyremainingyoptionsyidentifyycomponentsyofytheypsychotherapeuticy
managementyprocess.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yAnalysisyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
7. Whichystatementymostyaccuratelyydescribesyaynurse’syroleyregardingypsychopharmacology?
a. “YouywillyneedytoyfrequentlyymakeydecisionsyregardingytheyadministrationyofyPRNy
medicationsytoyhelpytheyclientymanageyanger.”
b. “It’syaynursingyresponsibilityytoyadjustyaymedicationydoseytoyassureyeffectiveypatientyr
esponses.”
c. “Nursesyadministersymedicationsywhileyevaluatingydrugyeffectivenessyisyaymedicalyr
esponsibility.”
d. “Toybestyassureyappropriateyresponse,yaypatient’syquestionsyaboutydrugytherapyy
shouldybeyreferredytoytheypsychiatrist.”
ANS:y A
NursingyassessmentyandyanalN ysUisRoS
fydIaN
taGmTigBh.
tysCuO
ggMestytheyneedyforyPRNymedicationyasypatient
yanxietyyincreases yor ypsychoticysymptoms ybecomeymoreyacute.yTheynurseyis ytheyhealth
teamymemberywhoymakesythisydetermination.yNursesyareyresponsibleyforymonitoringydrugyeffect
ivenessyasywellyasyadministeringymedication.yNursesyshouldyassumeyresponsibilityyforyteachingy
patientsyaboutytheysideyeffectsyofymedications.yNursesycannotyalteryprescribedydosagesyofymedica
tionsyunlessytheyyhaveyprescriptiveyprivileges.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yAnalysisyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
8. Whenyconsideringyenvironmentalyaspectsyofymilieuymanagement,ywhichyinterventionyhasythey
highestypriorityyforyayclientyadmittedyafteryayfailedysuicideyattempt?
a. Sendingytheyclient’synewymedicationyprescriptionsytoytheypharmacy
b. Assigningyaystaffymemberytoyone-on-oneyobservationyofytheyclient
c. Orientingytheyclientytoytheymilieu’sypublicyandyprivateyspaces
d. Havingyallypotentiallyydangerousyitemsyremovedyfromytheyclient’sybelongings
ANS:y B
Milieuymanagementyprovidesyayproactiveyapproachytoycare.ySafetyyoverridesyallyotherydimensio
nsyofytheymilieu.yInitiationyofysuicideyprecautionsyareytheypriorityyforythisyclient.yAllytheyremaini
ngyoptionsyareyappropriateybutynoneyprotectytheyclientyfromytheyriskyofyanotheryattemptytoyself-
harmyasyeffectivelyyasyone-on-oneyobservationyasypartyofysuicideyprecautions.
DIF: Cognitiveylevel:yAnalyzing TOP:y Nursingyprocess:yImplementation
NURSINGTB.COM
Chapter 01: Med, Meds, Milieu
y y y y
Keltner: Psychiatric Nursing, 8th Edition
y y y y
MULTIPLEyCHOICE
1. Aynewlyylicensedyasksyaynursingyrecruiteryforyaydescriptionyofynursingypracticeyinytheyp
sychiatricysetting.yWhatyisytheynurseyrecruiter’sybestyresponse?
a. “Theynurseyprimarilyyservesyinyaysupportiveyroleytoymembersyofytheyhealthycareyd
eliveryyteam.”
b. “Theymultidisciplinaryyapproachyeliminatesytheyneedytoyclearlyydefineytheyr
esponsibilitiesyofynursingyinysuchyaysetting.”
c. “Nursingyactionsyareyidentifiedybyytheyinstitutionythatydistinguishesynursingyfromy
otherymentalyhealthyprofessions.”
d. “Nursingyoffersyuniqueycontributionsytoytheypsychotherapeuticymanagementyofy
psychiatricypatients.”
ANS:y D
Professionalyroleyoverlapycannotybeydenied;yhowever,ynursingyisyuniqueyinyitsyfocusyonyandyappl
icationyofypsychotherapeuticymanagement.yNeitherytheyfacilityynorytheymultidisciplinaryyteamyd
efineytheyprofessionalyresponsibilitiesyofyitsymembersybutyratheryutilizesytheiryuniqueyskillsytoypr
ovideyholisticycare.yIdeally,yallyteamymembersysupportyeachyotheryandyhaveyfunctionsywithinyth
eyteam.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yImplementationyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
N R I G B.C M
Ug pSroceNssywTill theOnurseyfocusyuponytoyaddressytheyr
2. Whichycomponentyofytheynursin
esponsibilityytoymatchyindividualypatientyneedsywithyappropriateyservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:y C
Properyassessmentyisycriticalyforybeingyableytoydetermineytheyappropriateylevelyofyservicesythatywi
llyprovideyoptimalycareywhileyconsideringypatientyinputyandyatytheylowestycost.yPlanningyandyimp
lementationyutilizesytheyassessmentydataytoyidentifyyandyexecuteyactionsy(treatmentyplan)ythatywil
lyprovideyappropriateycare.yEvaluationyvalidatesytheyeffectivenessyofytheytreatmentyplan.
DIF: Cognitiveylevel:yApplying
TOP:y Nursingyprocess:yAssessmentyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
3. Anyadultydiagnosedywithyparanoidyschizophreniayfrequentyexperiencesyauditoryyhallucinationsy
andywalksyaboutytheyunit,ymuttering.yWhichynursingyactionydemonstratesytheynurse’syunderstan
dingyofyeffectiveypsychotherapeuticymanagementyofythisyclient?
a. Discussingytheydiseaseyprocessyofyschizophreniaywithytheyclientyandytheirydomesticy
partner
b. Minimizingycontactybetweenythisypatientyandyotherypatientsytoyassureyaystressyfreey
milieu
c. AdministeringyPRNymedicationywhenyfirstyobservingytheyevidenceythatytheyclient
NURSINGTB.COM
, PsychiatricyNursingy8thyEditionyKeltneryTestyBank
mayybeyhallucinating
d. Independentlyydeterminingythatybehaviorymodificationyisyappropriateytoydecreaseyt
heyclient’syparanoidythoughts
ANS:y A
Anyunderstandingyofypsychopathologyyisytheyfoundationyonywhichytheythreeycomponentsyofypsych
otherapeuticymanagementyrest;yityfacilitatesytherapeuticycommunicationyandyprovidesyaybasisyforyu
nderstandingypsychopharmacologyyandymilieuymanagement.yMinimizingycontactybetweenytheypa
tientyandyothersyandyadministeringyPRNymedicationyindiscriminatelyyareynontherapeuticyinterven
tions.yUsingybehaviorymodificationytoydecreaseytheyfrequencyyofyhallucinationsywouldyneedytoybey
incorporatedyintoytheyplanyofycareybyytheycareyteam.
DIF: Cognitiveylevel:yApplying
TOP:y Nursingyprocess:yImplementationyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
4. Anyadultydiagnosedywithychronicydepressionyisyhospitalizedyafteryaysuicideyattempt.yWhichyi
nterventionyisycriticalyinyassuringylong-
term,yeffectiveyclientycareyasydescribedybyypsychotherapeuticymanagement?
a. Involvementyinygroupytherapies
b. Focusyofycloseysupervisionybyytheyunitystaff
c. Maintainingyeffectiveycommunicationywithysupportysystem
d. Frequentlyyscheduledyone-on-oneytimeywithynursingystaff
ANS:y D
Aycriticalyelementyofypsychotherapeuticymanagementyisytheypresenceyofyaytherapeutic
nurse-patientyrelationship.yOne-on-
oneytimeywithynursingystaffywillyhelpyinyestablishingythisyconnection.yWhileytheyotheryoptionsyar
eyappropriateyandyclientycentered,ytheynurse-clientyrelationyisycriticalyinytheyl o n g N
-
RSdeIliNveGrT
teUrm yyB
of.qC
uaOliM
tyyeffectiveycareytoythisyclient.
DIF: Cognitiveylevel:yApplying
TOP:y Nursingyprocess:yImplementationyMSC:y ClientyNeeds:yPsychosocialyIn
tegrity
5. Aypatient’syhaloperidolydosageywasyreducedy2yweeksyagoytoydecreaseysideyeffects.yWhatyas
sessmentyquestionydemonstratesytheynurse’syunderstandingyofytheyresultingyneedsyofytheycli
ent?
a. “Willyyouyhaveyanyydifficultyygettingyyouryprescriptionyrefilled?”
b. “Haveyyouybegunyexperiencingyanyyformsyofyhallucinations?”
c. “Whatydoyyouyexpectywillyoccurysinceytheydosageyhasybeenyreduced?”
d. “WhatycanyIydoytoyhelpyyouymanageythisyreductionyinyhaloperidolytherapy?”
ANS:y B
Itywillybeynecessaryyforytheynurseytoyassessyforyexacerbationyofytheypatient’sysymptomsyofypsych
osisyasywellyasyforyaylesseningyofysideyeffects.yDosageydecreaseymightyleadytoytheyreturnyoryworse
ningyofypositiveysymptomsysuchyasyhallucinationsyandydelusions,yandynegativeysymptomsysuchy
asybluntedyaffect,ysocialywithdrawal,yandypoorygrooming.yWhileytheyotheryoptionsymayybeyappro
priateyassessmentyquestions,ytheyyareynotydirectedyatytheycurrentyneedsyofytheyclient;ytheyidentific
ationyofyemergingypsychoticybehaviors.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yAssessmentyMSC:y ClientyNeeds:yPhysiologicyInt
egrity
NURSINGTB.COM
, PsychiatricyNursingy8thyEditionyKeltneryTestyBank
6. Whichystatementyformsytheyfoundationyuponywhichyaynurseyshouldybaseytheyimplementationyofyp
sychotherapeuticymanagementytoytheycareyofyaypatientywithymentalyillness?
a. Theynurse’syroleyinyclientycareyisysupportedybyytheymultidisciplinaryyteam.
b. Omittingyanyyoneycomponentywillycompromiseytheyeffectivenessyofytheytreatment.
c. Theymostyimportantyelementyofypsychotherapeuticymanagementyisydrugytherapy.
d. Aytherapeuticynurse-patientyrelationshipyisytheymostyimportantyaspectyofytreatment.
ANS:y B
Whenyoneyelementyisymissing,ytreatmentyisyusuallyycompromised.yNoysingleyelementyisymoreyi
mportantythanytheyothers;yhowever,ypatients’yneedsygovernytheyapplicationyofytheycomponentsya
ndypermityjudiciousyuse.yTheyremainingyoptionsyidentifyycomponentsyofytheypsychotherapeuticy
managementyprocess.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yAnalysisyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
7. Whichystatementymostyaccuratelyydescribesyaynurse’syroleyregardingypsychopharmacology?
a. “YouywillyneedytoyfrequentlyymakeydecisionsyregardingytheyadministrationyofyPRNy
medicationsytoyhelpytheyclientymanageyanger.”
b. “It’syaynursingyresponsibilityytoyadjustyaymedicationydoseytoyassureyeffectiveypatientyr
esponses.”
c. “Nursesyadministersymedicationsywhileyevaluatingydrugyeffectivenessyisyaymedicalyr
esponsibility.”
d. “Toybestyassureyappropriateyresponse,yaypatient’syquestionsyaboutydrugytherapyy
shouldybeyreferredytoytheypsychiatrist.”
ANS:y A
NursingyassessmentyandyanalN ysUisRoS
fydIaN
taGmTigBh.
tysCuO
ggMestytheyneedyforyPRNymedicationyasypatient
yanxietyyincreases yor ypsychoticysymptoms ybecomeymoreyacute.yTheynurseyis ytheyhealth
teamymemberywhoymakesythisydetermination.yNursesyareyresponsibleyforymonitoringydrugyeffect
ivenessyasywellyasyadministeringymedication.yNursesyshouldyassumeyresponsibilityyforyteachingy
patientsyaboutytheysideyeffectsyofymedications.yNursesycannotyalteryprescribedydosagesyofymedica
tionsyunlessytheyyhaveyprescriptiveyprivileges.
DIF: Cognitiveylevel:yAnalyzing
TOP:y Nursingyprocess:yAnalysisyMSC:y ClientyNeeds:ySafe,yEffectivey
CareyEnvironment
8. Whenyconsideringyenvironmentalyaspectsyofymilieuymanagement,ywhichyinterventionyhasythey
highestypriorityyforyayclientyadmittedyafteryayfailedysuicideyattempt?
a. Sendingytheyclient’synewymedicationyprescriptionsytoytheypharmacy
b. Assigningyaystaffymemberytoyone-on-oneyobservationyofytheyclient
c. Orientingytheyclientytoytheymilieu’sypublicyandyprivateyspaces
d. Havingyallypotentiallyydangerousyitemsyremovedyfromytheyclient’sybelongings
ANS:y B
Milieuymanagementyprovidesyayproactiveyapproachytoycare.ySafetyyoverridesyallyotherydimensio
nsyofytheymilieu.yInitiationyofysuicideyprecautionsyareytheypriorityyforythisyclient.yAllytheyremaini
ngyoptionsyareyappropriateybutynoneyprotectytheyclientyfromytheyriskyofyanotheryattemptytoyself-
harmyasyeffectivelyyasyone-on-oneyobservationyasypartyofysuicideyprecautions.
DIF: Cognitiveylevel:yAnalyzing TOP:y Nursingyprocess:yImplementation
NURSINGTB.COM
