,MULTIPLE .CHOICE
1. A .newly .licensed .asks .a .nursing .recruiter .for .a .description .of .nursing .practice .in
.the .psychiatric .setting. .What .is .the .nurse .recruiter‘s .best .response?
a. ―The .nurse .primarily .serves .in .a .supportive .role .to .members .of .the .health .care
delivery .team.‖
b. ―The .multidisciplinary .approach .eliminates .the .need .to .clearly .define .the
responsibilities .of .nursing .in .such .a .setting.‖
c. ―Nursing .actions .are .identified .by .the .institution .that .distinguishes .nursing
.from
other .mental .health .professions.‖
d. ―Nursing .offers .unique .contributions .to .the .psychotherapeutic .management .of
psychiatric .patients.‖
ANS: . D
Professional .role .overlap .cannot .be .denied; .however, .nursing .is .unique .in .its .focus .on .and
.application .of .psychotherapeutic .management. .Neither .the .facility .nor .the .multidisciplinary
.team .define .the .professional .responsibilities .of .its .members .but .rather .utilizes .their .unique
.skills .to .provide .holistic .care. .Ideally, .all .team .members .support .each .other .and .have
.functions .within .the .team.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Implementation .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
2. Which .component .of .the .nursing .process .will .the .nurse .focus .upon .to .address
.the .responsibility .to .match .individual .patient .needs .with .appropriate .services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: . C
Proper .assessment .is .critical .for .being .able .to .determine .the .appropriate .level .of .services
.that .will .provide .optimal .care .while .considering .patient .input .and .at .the .lowest .cost.
.Planning .and .implementation .utilizes .the .assessment .data .to .identify .and .execute .actions
.(treatment .plan) .that .will .provide .appropriate .care. .Evaluation .validates .the .effectiveness .of
.the .treatment .plan.
DIF: Cognitive .level: .Applying TOP: . Nursing .process:
.Assessment .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
3. An .adult .diagnosed .with .paranoid .schizophrenia .frequent .experiences .auditory
.hallucinations .and .walks .about .the .unit, .muttering. .Which .nursing .action .demonstrates .the
.nurse‘s .understanding .of .effective .psychotherapeutic .management .of .this .client?
a. Discussing .the .disease .process .of .schizophrenia .with .the .client .and .their
.domestic
partner
b. Minimizing .contact .between .this .patient .and .other .patients .to .assure .a .stress
.free
milieu
, c. Administering .PRN .medication .when .first .observing .the .evidence .that .the .client
may .be .hallucinating
d. Independently .determining .that .behavior .modification .is .appropriate .to
.decrease
the .client‘s .paranoid .thoughts
ANS: . A
An .understanding .of .psychopathology .is .the .foundation .on .which .the .three .components .of
.psychotherapeutic .management .rest; .it .facilitates .therapeutic .communication .and .provides .a
.basis .for .understanding .psychopharmacology .and .milieu .management. .Minimizing .contact
.between .the .patient .and .others .and .administering .PRN .medication .indiscriminately .are
.nontherapeutic .interventions. .Using .behavior .modification .to .decrease .the .frequency .of
.hallucinations .would .need .to .be .incorporated .into .the .plan .of .care .by .the .care .team.
DIF: Cognitive .level: .Applying TOP: . Nursing .process:
.Implementation .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
4. An .adult .diagnosed .with .chronic .depression .is .hospitalized .after .a .suicide .attempt.
.Which .intervention .is .critical .in .assuring .long-term, .effective .client .care .as .described
.by .psychotherapeutic .management?
a. Involvement .in .group .therapies
b. Focus .of .close .supervision .by .the .unit .staff
c. Maintaining .effective .communication .with .support .system
d. Frequently .scheduled .one-on-one .time .with .nursing .staff
ANS: . D
A .critical .element .of .psychotherapeutic .management .is .the .presence .of .a .therapeutic
nurse-patient .relationship. .One-on-one .time .with .nursing .staff .will .help .in .establishing .this
.connection. .While .the .other .options .are .appropriate .and .client .centered, .the .nurse-client
.relation .is .critical .in .the .long-term .delivery .of .quality .effective .care .to .this .client.
DIF: Cognitive .level: .Applying TOP: . Nursing .process:
.Implementation .MSC: . Client .Needs: .Psychosocial .Integrity
5. A .patient‘s .haloperidol .dosage .was .reduced .2 .weeks .ago .to .decrease .side .effects.
.What .assessment .question .demonstrates .the .nurse‘s .understanding .of .the .resulting
.needs .of .the .client?
a. ―Will .you .have .any .difficulty .getting .your .prescription .refilled?‖
b. ―Have .you .begun .experiencing .any .forms .of .hallucinations?‖
c. ―What .do .you .expect .will .occur .since .the .dosage .has .been .reduced?‖
d. ―What .can .I .do .to .help .you .manage .this .reduction .in .haloperidol .therapy?‖
ANS: . B
It .will .be .necessary .for .the .nurse .to .assess .for .exacerbation .of .the .patient‘s .symptoms .of
.psychosis .as .well .as .for .a .lessening .of .side .effects. .Dosage .decrease .might .lead .to .the
.return .or .worsening .of .positive .symptoms .such .as .hallucinations .and .delusions, .and
.negative .symptoms .such .as .blunted .affect, .social .withdrawal, .and .poor .grooming. .While
.the .other .options .may .be .appropriate .assessment .questions, .they .are .not .directed .at .the
.current .needs .of .the .client; .the .identification .of .emerging .psychotic .behaviors.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Assessment .MSC: . Client .Needs: .Physiologic .Integrity
, 6. Which .statement .forms .the .foundation .upon .which .a .nurse .should .base .the .implementation
.of .psychotherapeutic .management .to .the .care .of .a .patient .with .mental .illness?
a. The .nurse‘s .role .in .client .care .is .supported .by .the .multidisciplinary .team.
b. Omitting .any .one .component .will .compromise .the .effectiveness .of .the
.treatment.
c. The .most .important .element .of .psychotherapeutic .management .is .drug .therapy.
d. A .therapeutic .nurse-patient .relationship .is .the .most .important .aspect .of
.treatment.
ANS: . B
When .one .element .is .missing, .treatment .is .usually .compromised. .No .single .element .is
.more .important .than .the .others; .however, .patients‘ .needs .govern .the .application .of .the
.components .and .permit .judicious .use. .The .remaining .options .identify .components .of .the
.psychotherapeutic .management .process.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Analysis .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
7. Which .statement .most .accurately .describes .a .nurse‘s .role .regarding .psychopharmacology?
a. ―You .will .need .to .frequently .make .decisions .regarding .the .administration .of
.PRN
medications .to .help .the .client .manage .anger.‖
b. ―It‘s .a .nursing .responsibility .to .adjust .a .medication .dose .to .assure .effective .patient
.responses.‖
c. ―Nurses .administers .medications .while .evaluating .drug .effectiveness .is .a .medical
.responsibility.‖
d. ―To .best .assure .appropriate .response, .a .patient‘s .questions .about .drug
.therapy .should .be .referred .to .the .psychiatrist.‖
ANS: . A
Nursing .assessment .and .analysis .of .data .might .suggest .the .need .for .PRN .medication .as
.patient .anxiety .increases .or .psychotic .symptoms .become .more .acute. .The .nurse .is .the
.health .team .member .who .makes .this .determination. .Nurses .are .responsible .for .monitoring
.drug .effectiveness .as .well .as .administering .medication. .Nurses .should .assume
.responsibility .for .teaching .patients .about .the .side .effects .of .medications. .Nurses .cannot
.alter .prescribed .dosages .of .medications .unless .they .have .prescriptive .privileges.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Analysis .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
8. When .considering .environmental .aspects .of .milieu .management, .which .intervention .has
.the .highest .priority .for .a .client .admitted .after .a .failed .suicide .attempt?
a. Sending .the .client‘s .new .medication .prescriptions .to .the .pharmacy
b. Assigning .a .staff .member .to .one-on-one .observation .of .the .client
c. Orienting .the .client .to .the .milieu‘s .public .and .private .spaces
d. Having .all .potentially .dangerous .items .removed .from .the .client‘s
.belongings
ANS: . B
Milieu .management .provides .a .proactive .approach .to .care. .Safety .overrides .all .other
.dimensions .of .the .milieu. .Initiation .of .suicide .precautions .are .the .priority .for .this .client.
.All .the .remaining .options .are .appropriate .but .none .protect .the .client .from .the .risk .of
.another .attempt .to .self-harm .as .effectively .as .one-on-one .observation .as .part .of .suicide
.precautions.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process: .Implementation
1. A .newly .licensed .asks .a .nursing .recruiter .for .a .description .of .nursing .practice .in
.the .psychiatric .setting. .What .is .the .nurse .recruiter‘s .best .response?
a. ―The .nurse .primarily .serves .in .a .supportive .role .to .members .of .the .health .care
delivery .team.‖
b. ―The .multidisciplinary .approach .eliminates .the .need .to .clearly .define .the
responsibilities .of .nursing .in .such .a .setting.‖
c. ―Nursing .actions .are .identified .by .the .institution .that .distinguishes .nursing
.from
other .mental .health .professions.‖
d. ―Nursing .offers .unique .contributions .to .the .psychotherapeutic .management .of
psychiatric .patients.‖
ANS: . D
Professional .role .overlap .cannot .be .denied; .however, .nursing .is .unique .in .its .focus .on .and
.application .of .psychotherapeutic .management. .Neither .the .facility .nor .the .multidisciplinary
.team .define .the .professional .responsibilities .of .its .members .but .rather .utilizes .their .unique
.skills .to .provide .holistic .care. .Ideally, .all .team .members .support .each .other .and .have
.functions .within .the .team.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Implementation .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
2. Which .component .of .the .nursing .process .will .the .nurse .focus .upon .to .address
.the .responsibility .to .match .individual .patient .needs .with .appropriate .services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: . C
Proper .assessment .is .critical .for .being .able .to .determine .the .appropriate .level .of .services
.that .will .provide .optimal .care .while .considering .patient .input .and .at .the .lowest .cost.
.Planning .and .implementation .utilizes .the .assessment .data .to .identify .and .execute .actions
.(treatment .plan) .that .will .provide .appropriate .care. .Evaluation .validates .the .effectiveness .of
.the .treatment .plan.
DIF: Cognitive .level: .Applying TOP: . Nursing .process:
.Assessment .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
3. An .adult .diagnosed .with .paranoid .schizophrenia .frequent .experiences .auditory
.hallucinations .and .walks .about .the .unit, .muttering. .Which .nursing .action .demonstrates .the
.nurse‘s .understanding .of .effective .psychotherapeutic .management .of .this .client?
a. Discussing .the .disease .process .of .schizophrenia .with .the .client .and .their
.domestic
partner
b. Minimizing .contact .between .this .patient .and .other .patients .to .assure .a .stress
.free
milieu
, c. Administering .PRN .medication .when .first .observing .the .evidence .that .the .client
may .be .hallucinating
d. Independently .determining .that .behavior .modification .is .appropriate .to
.decrease
the .client‘s .paranoid .thoughts
ANS: . A
An .understanding .of .psychopathology .is .the .foundation .on .which .the .three .components .of
.psychotherapeutic .management .rest; .it .facilitates .therapeutic .communication .and .provides .a
.basis .for .understanding .psychopharmacology .and .milieu .management. .Minimizing .contact
.between .the .patient .and .others .and .administering .PRN .medication .indiscriminately .are
.nontherapeutic .interventions. .Using .behavior .modification .to .decrease .the .frequency .of
.hallucinations .would .need .to .be .incorporated .into .the .plan .of .care .by .the .care .team.
DIF: Cognitive .level: .Applying TOP: . Nursing .process:
.Implementation .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
4. An .adult .diagnosed .with .chronic .depression .is .hospitalized .after .a .suicide .attempt.
.Which .intervention .is .critical .in .assuring .long-term, .effective .client .care .as .described
.by .psychotherapeutic .management?
a. Involvement .in .group .therapies
b. Focus .of .close .supervision .by .the .unit .staff
c. Maintaining .effective .communication .with .support .system
d. Frequently .scheduled .one-on-one .time .with .nursing .staff
ANS: . D
A .critical .element .of .psychotherapeutic .management .is .the .presence .of .a .therapeutic
nurse-patient .relationship. .One-on-one .time .with .nursing .staff .will .help .in .establishing .this
.connection. .While .the .other .options .are .appropriate .and .client .centered, .the .nurse-client
.relation .is .critical .in .the .long-term .delivery .of .quality .effective .care .to .this .client.
DIF: Cognitive .level: .Applying TOP: . Nursing .process:
.Implementation .MSC: . Client .Needs: .Psychosocial .Integrity
5. A .patient‘s .haloperidol .dosage .was .reduced .2 .weeks .ago .to .decrease .side .effects.
.What .assessment .question .demonstrates .the .nurse‘s .understanding .of .the .resulting
.needs .of .the .client?
a. ―Will .you .have .any .difficulty .getting .your .prescription .refilled?‖
b. ―Have .you .begun .experiencing .any .forms .of .hallucinations?‖
c. ―What .do .you .expect .will .occur .since .the .dosage .has .been .reduced?‖
d. ―What .can .I .do .to .help .you .manage .this .reduction .in .haloperidol .therapy?‖
ANS: . B
It .will .be .necessary .for .the .nurse .to .assess .for .exacerbation .of .the .patient‘s .symptoms .of
.psychosis .as .well .as .for .a .lessening .of .side .effects. .Dosage .decrease .might .lead .to .the
.return .or .worsening .of .positive .symptoms .such .as .hallucinations .and .delusions, .and
.negative .symptoms .such .as .blunted .affect, .social .withdrawal, .and .poor .grooming. .While
.the .other .options .may .be .appropriate .assessment .questions, .they .are .not .directed .at .the
.current .needs .of .the .client; .the .identification .of .emerging .psychotic .behaviors.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Assessment .MSC: . Client .Needs: .Physiologic .Integrity
, 6. Which .statement .forms .the .foundation .upon .which .a .nurse .should .base .the .implementation
.of .psychotherapeutic .management .to .the .care .of .a .patient .with .mental .illness?
a. The .nurse‘s .role .in .client .care .is .supported .by .the .multidisciplinary .team.
b. Omitting .any .one .component .will .compromise .the .effectiveness .of .the
.treatment.
c. The .most .important .element .of .psychotherapeutic .management .is .drug .therapy.
d. A .therapeutic .nurse-patient .relationship .is .the .most .important .aspect .of
.treatment.
ANS: . B
When .one .element .is .missing, .treatment .is .usually .compromised. .No .single .element .is
.more .important .than .the .others; .however, .patients‘ .needs .govern .the .application .of .the
.components .and .permit .judicious .use. .The .remaining .options .identify .components .of .the
.psychotherapeutic .management .process.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Analysis .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
7. Which .statement .most .accurately .describes .a .nurse‘s .role .regarding .psychopharmacology?
a. ―You .will .need .to .frequently .make .decisions .regarding .the .administration .of
.PRN
medications .to .help .the .client .manage .anger.‖
b. ―It‘s .a .nursing .responsibility .to .adjust .a .medication .dose .to .assure .effective .patient
.responses.‖
c. ―Nurses .administers .medications .while .evaluating .drug .effectiveness .is .a .medical
.responsibility.‖
d. ―To .best .assure .appropriate .response, .a .patient‘s .questions .about .drug
.therapy .should .be .referred .to .the .psychiatrist.‖
ANS: . A
Nursing .assessment .and .analysis .of .data .might .suggest .the .need .for .PRN .medication .as
.patient .anxiety .increases .or .psychotic .symptoms .become .more .acute. .The .nurse .is .the
.health .team .member .who .makes .this .determination. .Nurses .are .responsible .for .monitoring
.drug .effectiveness .as .well .as .administering .medication. .Nurses .should .assume
.responsibility .for .teaching .patients .about .the .side .effects .of .medications. .Nurses .cannot
.alter .prescribed .dosages .of .medications .unless .they .have .prescriptive .privileges.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process:
.Analysis .MSC: . Client .Needs: .Safe, .Effective .Care .Environment
8. When .considering .environmental .aspects .of .milieu .management, .which .intervention .has
.the .highest .priority .for .a .client .admitted .after .a .failed .suicide .attempt?
a. Sending .the .client‘s .new .medication .prescriptions .to .the .pharmacy
b. Assigning .a .staff .member .to .one-on-one .observation .of .the .client
c. Orienting .the .client .to .the .milieu‘s .public .and .private .spaces
d. Having .all .potentially .dangerous .items .removed .from .the .client‘s
.belongings
ANS: . B
Milieu .management .provides .a .proactive .approach .to .care. .Safety .overrides .all .other
.dimensions .of .the .milieu. .Initiation .of .suicide .precautions .are .the .priority .for .this .client.
.All .the .remaining .options .are .appropriate .but .none .protect .the .client .from .the .risk .of
.another .attempt .to .self-harm .as .effectively .as .one-on-one .observation .as .part .of .suicide
.precautions.
DIF: Cognitive .level: .Analyzing TOP: . Nursing .process: .Implementation
