, PsychiatriclNursingl8thlEditionlKeltnerlTestlBank
Chapter 01: Med, Meds, Milieu
l l l l
Keltner: Psychiatric Nursing, 8th Edition
l l l l
MULTIPLElCHOICE
1. Alnewlyllicensedlaskslalnursinglrecruiterlforlaldescriptionloflnursinglpracticelinlthelpsyc
hiatriclsetting.lWhatlislthelnurselrecruiter’slbestlresponse?
a. “Thelnurselprimarilylserveslinlalsupportivelroleltolmembersloflthelhealthlcareldeli
verylteam.”
b. “Thelmultidisciplinarylapproachleliminateslthelneedltolclearlyldefinelthelres
ponsibilitiesloflnursinglinlsuchlalsetting.”
c. “Nursinglactionslarelidentifiedlbylthelinstitutionlthatldistinguisheslnursinglfromloth
erlmentallhealthlprofessions.”
d. “Nursingloffersluniquelcontributionsltolthelpsychotherapeuticlmanagementloflps
ychiatriclpatients.”
ANS:l D
Professionallroleloverlaplcannotlbeldenied;lhowever,lnursinglisluniquelinlitslfocuslonlandlapplic
ationloflpsychotherapeuticlmanagement.lNeitherlthelfacilitylnorlthelmultidisciplinarylteamldefi
nelthelprofessionallresponsibilitiesloflitslmemberslbutlratherlutilizesltheirluniquelskillsltolprovi
delholisticlcare.lIdeally,lalllteamlmemberslsupportleachlotherlandlhavelfunctionslwithinltheltea
m.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lImplementationlMSC:l ClientlNeeds:lSafe,lEffectivelCar
elEnvironment
N R I G B.C M
Ug pSroceNsslwTill theOnurselfocusluponltoladdresslthelres
2. Whichlcomponentloflthelnursin
ponsibilityltolmatchlindividuallpatientlneedslwithlappropriatelservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:l C
Properlassessmentlislcriticallforlbeinglableltoldeterminelthelappropriatellevelloflserviceslthatlwilllp
rovideloptimallcarelwhilelconsideringlpatientlinputlandlatlthellowestlcost.lPlanninglandlimplement
ationlutilizeslthelassessmentldataltolidentifylandlexecutelactionsl(treatmentlplan)lthatlwilllprovidel
appropriatelcare.lEvaluationlvalidatesltheleffectivenesslofltheltreatmentlplan.
DIF: Cognitivellevel:lApplying
TOP:l Nursinglprocess:lAssessmentlMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
3. Anladultldiagnosedlwithlparanoidlschizophrenialfrequentlexperienceslauditorylhallucinationslan
dlwalkslaboutlthelunit,lmuttering.lWhichlnursinglactionldemonstrateslthelnurse’slunderstandingl
ofleffectivelpsychotherapeuticlmanagementloflthislclient?
a. Discussingltheldiseaselprocessloflschizophrenialwithlthelclientlandltheirldomesticlpar
tner
b. Minimizinglcontactlbetweenlthislpatientlandlotherlpatientsltolassurelalstresslfreelmili
eu
c. AdministeringlPRNlmedicationlwhenlfirstlobservinglthelevidencelthatlthelclient
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maylbelhallucinating
d. Independentlyldetermininglthatlbehaviorlmodificationlislappropriateltoldecreaselth
elclient’slparanoidlthoughts
ANS:l A
Anlunderstandingloflpsychopathologylislthelfoundationlonlwhichlthelthreelcomponentsloflpsyc
hotherapeuticlmanagementlrest;litlfacilitatesltherapeuticlcommunicationlandlprovideslalbasislfo
rlunderstandinglpsychopharmacologylandlmilieulmanagement.lMinimizinglcontactlbetweenlth
elpatientlandlotherslandladministeringlPRNlmedicationlindiscriminatelylarelnontherapeuticlint
erventions.lUsinglbehaviorlmodificationltoldecreaselthelfrequencyloflhallucinationslwouldlnee
dltolbelincorporatedlintolthelplanloflcarelbylthelcarelteam.
DIF: Cognitivellevel:lApplying
TOP:l Nursinglprocess:lImplementationlMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
4. Anladultldiagnosedlwithlchronicldepressionlislhospitalizedlafterlalsuicidelattempt.lWhichlinte
rventionlislcriticallinlassuringllong-
term,leffectivelclientlcarelasldescribedlbylpsychotherapeuticlmanagement?
a. Involvementlinlgroupltherapies
b. Focusloflcloselsupervisionlbylthelunitlstaff
c. Maintainingleffectivelcommunicationlwithlsupportlsystem
d. Frequentlylscheduledlone-on-oneltimelwithlnursinglstaff
ANS:l D
Alcriticallelementloflpsychotherapeuticlmanagementlislthelpresenceloflaltherapeutic
nurse-patientlrelationship.lOne-on-
oneltimelwithlnursinglstafflwilllhelplinlestablishinglthislconnection.lWhilelthelotherloptionslarel
appropriatelandlclientlcentered,lthelnurse-clientlrelationlislcriticallinlthellongN
-
RSdeIliNveGrT
teUrm ylB
of.qC
uaOliM
tyleffectivelcareltolthislclient.
DIF: Cognitivellevel:lApplying
TOP:l Nursinglprocess:lImplementationlMSC:l ClientlNeeds:lPsychosociallInte
grity
5. Alpatient’slhaloperidolldosagelwaslreducedl2lweekslagoltoldecreaselsideleffects.lWhatlasses
smentlquestionldemonstrateslthelnurse’slunderstandingloflthelresultinglneedsloflthelclient?
a. “Willlyoulhavelanyldifficultylgettinglyourlprescriptionlrefilled?”
b. “Havelyoulbegunlexperiencinglanylformsloflhallucinations?”
c. “Whatldolyoulexpectlwillloccurlsinceltheldosagelhaslbeenlreduced?”
d. “WhatlcanlIldoltolhelplyoulmanagelthislreductionlinlhaloperidolltherapy?”
ANS:l B
Itlwilllbelnecessarylforlthelnurseltolassesslforlexacerbationloflthelpatient’slsymptomsloflpsychosisl
aslwelllaslforlallesseningloflsideleffects.lDosageldecreaselmightlleadltolthelreturnlorlworseningloflp
ositivelsymptomslsuchlaslhallucinationslandldelusions,landlnegativelsymptomslsuchlaslbluntedlaf
fect,lsociallwithdrawal,landlpoorlgrooming.lWhilelthelotherloptionslmaylbelappropriatelassessme
ntlquestions,ltheylarelnotldirectedlatlthelcurrentlneedsloflthelclient;lthelidentificationloflemerginglp
sychoticlbehaviors.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lAssessmentlMSC:l ClientlNeeds:lPhysiologiclIntegr
ity
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, PsychiatriclNursingl8thlEditionlKeltnerlTestlBank
6. Whichlstatementlformslthelfoundationluponlwhichlalnurselshouldlbaselthelimplementationloflpsy
chotherapeuticlmanagementltolthelcareloflalpatientlwithlmentallillness?
a. Thelnurse’slrolelinlclientlcarelislsupportedlbylthelmultidisciplinarylteam.
b. Omittinglanylonelcomponentlwilllcompromiseltheleffectivenesslofltheltreatment.
c. Thelmostlimportantlelementloflpsychotherapeuticlmanagementlisldrugltherapy.
d. Altherapeuticlnurse-patientlrelationshiplislthelmostlimportantlaspectlofltreatment.
ANS:l B
Whenlonelelementlislmissing,ltreatmentlislusuallylcompromised.lNolsinglelelementlislmorelimpo
rtantlthanlthelothers;lhowever,lpatients’lneedslgovernlthelapplicationloflthelcomponentslandlperm
itljudiciousluse.lThelremainingloptionslidentifylcomponentsloflthelpsychotherapeuticlmanageme
ntlprocess.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lAnalysislMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
7. Whichlstatementlmostlaccuratelyldescribeslalnurse’slrolelregardinglpsychopharmacology?
a. “YoulwilllneedltolfrequentlylmakeldecisionslregardingltheladministrationloflPRNlme
dicationsltolhelplthelclientlmanagelanger.”
b. “It’slalnursinglresponsibilityltoladjustlalmedicationldoseltolassureleffectivelpatientlresp
onses.”
c. “Nursesladministerslmedicationslwhilelevaluatingldrugleffectivenesslislalmedicallres
ponsibility.”
d. “Tolbestlassurelappropriatelresponse,lalpatient’slquestionslaboutldrugltherapylsho
uldlbelreferredltolthelpsychiatrist.”
ANS:l A
NursinglassessmentlandlanalN isRoS
ysU fldIaN
taGmTigBh.
tlsCuO
ggMestlthelneedlforlPRNlmedicationlaslpatientla
nxietylincreaseslorlpsychoticlsymptomslbecomelmorelacute.lThelnurselislthelhealth
teamlmemberlwholmakeslthisldetermination.lNurseslarelresponsiblelforlmonitoringldrugleffective
nesslaslwelllasladministeringlmedication.lNurseslshouldlassumelresponsibilitylforlteachinglpatien
tslaboutlthelsideleffectsloflmedications.lNurseslcannotlalterlprescribedldosagesloflmedicationslunle
ssltheylhavelprescriptivelprivileges.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lAnalysislMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
8. Whenlconsideringlenvironmentallaspectsloflmilieulmanagement,lwhichlinterventionlhaslthelhig
hestlprioritylforlalclientladmittedlafterlalfailedlsuicidelattempt?
a. Sendinglthelclient’slnewlmedicationlprescriptionsltolthelpharmacy
b. Assigninglalstafflmemberltolone-on-onelobservationloflthelclient
c. Orientinglthelclientltolthelmilieu’slpubliclandlprivatelspaces
d. Havinglalllpotentiallyldangerouslitemslremovedlfromlthelclient’slbelongings
ANS:l B
Milieulmanagementlprovideslalproactivelapproachltolcare.lSafetyloverrideslalllotherldimension
sloflthelmilieu.lInitiationloflsuicidelprecautionslarelthelprioritylforlthislclient.lAlllthelremaininglo
ptionslarelappropriatelbutlnonelprotectlthelclientlfromlthelriskloflanotherlattemptltolself-
harmlasleffectivelylaslone-on-onelobservationlaslpartloflsuicidelprecautions.
DIF: Cognitivellevel:lAnalyzing TOP:l Nursinglprocess:lImplementation
NURSINGTB.COM
Chapter 01: Med, Meds, Milieu
l l l l
Keltner: Psychiatric Nursing, 8th Edition
l l l l
MULTIPLElCHOICE
1. Alnewlyllicensedlaskslalnursinglrecruiterlforlaldescriptionloflnursinglpracticelinlthelpsyc
hiatriclsetting.lWhatlislthelnurselrecruiter’slbestlresponse?
a. “Thelnurselprimarilylserveslinlalsupportivelroleltolmembersloflthelhealthlcareldeli
verylteam.”
b. “Thelmultidisciplinarylapproachleliminateslthelneedltolclearlyldefinelthelres
ponsibilitiesloflnursinglinlsuchlalsetting.”
c. “Nursinglactionslarelidentifiedlbylthelinstitutionlthatldistinguisheslnursinglfromloth
erlmentallhealthlprofessions.”
d. “Nursingloffersluniquelcontributionsltolthelpsychotherapeuticlmanagementloflps
ychiatriclpatients.”
ANS:l D
Professionallroleloverlaplcannotlbeldenied;lhowever,lnursinglisluniquelinlitslfocuslonlandlapplic
ationloflpsychotherapeuticlmanagement.lNeitherlthelfacilitylnorlthelmultidisciplinarylteamldefi
nelthelprofessionallresponsibilitiesloflitslmemberslbutlratherlutilizesltheirluniquelskillsltolprovi
delholisticlcare.lIdeally,lalllteamlmemberslsupportleachlotherlandlhavelfunctionslwithinltheltea
m.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lImplementationlMSC:l ClientlNeeds:lSafe,lEffectivelCar
elEnvironment
N R I G B.C M
Ug pSroceNsslwTill theOnurselfocusluponltoladdresslthelres
2. Whichlcomponentloflthelnursin
ponsibilityltolmatchlindividuallpatientlneedslwithlappropriatelservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:l C
Properlassessmentlislcriticallforlbeinglableltoldeterminelthelappropriatellevelloflserviceslthatlwilllp
rovideloptimallcarelwhilelconsideringlpatientlinputlandlatlthellowestlcost.lPlanninglandlimplement
ationlutilizeslthelassessmentldataltolidentifylandlexecutelactionsl(treatmentlplan)lthatlwilllprovidel
appropriatelcare.lEvaluationlvalidatesltheleffectivenesslofltheltreatmentlplan.
DIF: Cognitivellevel:lApplying
TOP:l Nursinglprocess:lAssessmentlMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
3. Anladultldiagnosedlwithlparanoidlschizophrenialfrequentlexperienceslauditorylhallucinationslan
dlwalkslaboutlthelunit,lmuttering.lWhichlnursinglactionldemonstrateslthelnurse’slunderstandingl
ofleffectivelpsychotherapeuticlmanagementloflthislclient?
a. Discussingltheldiseaselprocessloflschizophrenialwithlthelclientlandltheirldomesticlpar
tner
b. Minimizinglcontactlbetweenlthislpatientlandlotherlpatientsltolassurelalstresslfreelmili
eu
c. AdministeringlPRNlmedicationlwhenlfirstlobservinglthelevidencelthatlthelclient
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, PsychiatriclNursingl8thlEditionlKeltnerlTestlBank
maylbelhallucinating
d. Independentlyldetermininglthatlbehaviorlmodificationlislappropriateltoldecreaselth
elclient’slparanoidlthoughts
ANS:l A
Anlunderstandingloflpsychopathologylislthelfoundationlonlwhichlthelthreelcomponentsloflpsyc
hotherapeuticlmanagementlrest;litlfacilitatesltherapeuticlcommunicationlandlprovideslalbasislfo
rlunderstandinglpsychopharmacologylandlmilieulmanagement.lMinimizinglcontactlbetweenlth
elpatientlandlotherslandladministeringlPRNlmedicationlindiscriminatelylarelnontherapeuticlint
erventions.lUsinglbehaviorlmodificationltoldecreaselthelfrequencyloflhallucinationslwouldlnee
dltolbelincorporatedlintolthelplanloflcarelbylthelcarelteam.
DIF: Cognitivellevel:lApplying
TOP:l Nursinglprocess:lImplementationlMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
4. Anladultldiagnosedlwithlchronicldepressionlislhospitalizedlafterlalsuicidelattempt.lWhichlinte
rventionlislcriticallinlassuringllong-
term,leffectivelclientlcarelasldescribedlbylpsychotherapeuticlmanagement?
a. Involvementlinlgroupltherapies
b. Focusloflcloselsupervisionlbylthelunitlstaff
c. Maintainingleffectivelcommunicationlwithlsupportlsystem
d. Frequentlylscheduledlone-on-oneltimelwithlnursinglstaff
ANS:l D
Alcriticallelementloflpsychotherapeuticlmanagementlislthelpresenceloflaltherapeutic
nurse-patientlrelationship.lOne-on-
oneltimelwithlnursinglstafflwilllhelplinlestablishinglthislconnection.lWhilelthelotherloptionslarel
appropriatelandlclientlcentered,lthelnurse-clientlrelationlislcriticallinlthellongN
-
RSdeIliNveGrT
teUrm ylB
of.qC
uaOliM
tyleffectivelcareltolthislclient.
DIF: Cognitivellevel:lApplying
TOP:l Nursinglprocess:lImplementationlMSC:l ClientlNeeds:lPsychosociallInte
grity
5. Alpatient’slhaloperidolldosagelwaslreducedl2lweekslagoltoldecreaselsideleffects.lWhatlasses
smentlquestionldemonstrateslthelnurse’slunderstandingloflthelresultinglneedsloflthelclient?
a. “Willlyoulhavelanyldifficultylgettinglyourlprescriptionlrefilled?”
b. “Havelyoulbegunlexperiencinglanylformsloflhallucinations?”
c. “Whatldolyoulexpectlwillloccurlsinceltheldosagelhaslbeenlreduced?”
d. “WhatlcanlIldoltolhelplyoulmanagelthislreductionlinlhaloperidolltherapy?”
ANS:l B
Itlwilllbelnecessarylforlthelnurseltolassesslforlexacerbationloflthelpatient’slsymptomsloflpsychosisl
aslwelllaslforlallesseningloflsideleffects.lDosageldecreaselmightlleadltolthelreturnlorlworseningloflp
ositivelsymptomslsuchlaslhallucinationslandldelusions,landlnegativelsymptomslsuchlaslbluntedlaf
fect,lsociallwithdrawal,landlpoorlgrooming.lWhilelthelotherloptionslmaylbelappropriatelassessme
ntlquestions,ltheylarelnotldirectedlatlthelcurrentlneedsloflthelclient;lthelidentificationloflemerginglp
sychoticlbehaviors.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lAssessmentlMSC:l ClientlNeeds:lPhysiologiclIntegr
ity
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, PsychiatriclNursingl8thlEditionlKeltnerlTestlBank
6. Whichlstatementlformslthelfoundationluponlwhichlalnurselshouldlbaselthelimplementationloflpsy
chotherapeuticlmanagementltolthelcareloflalpatientlwithlmentallillness?
a. Thelnurse’slrolelinlclientlcarelislsupportedlbylthelmultidisciplinarylteam.
b. Omittinglanylonelcomponentlwilllcompromiseltheleffectivenesslofltheltreatment.
c. Thelmostlimportantlelementloflpsychotherapeuticlmanagementlisldrugltherapy.
d. Altherapeuticlnurse-patientlrelationshiplislthelmostlimportantlaspectlofltreatment.
ANS:l B
Whenlonelelementlislmissing,ltreatmentlislusuallylcompromised.lNolsinglelelementlislmorelimpo
rtantlthanlthelothers;lhowever,lpatients’lneedslgovernlthelapplicationloflthelcomponentslandlperm
itljudiciousluse.lThelremainingloptionslidentifylcomponentsloflthelpsychotherapeuticlmanageme
ntlprocess.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lAnalysislMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
7. Whichlstatementlmostlaccuratelyldescribeslalnurse’slrolelregardinglpsychopharmacology?
a. “YoulwilllneedltolfrequentlylmakeldecisionslregardingltheladministrationloflPRNlme
dicationsltolhelplthelclientlmanagelanger.”
b. “It’slalnursinglresponsibilityltoladjustlalmedicationldoseltolassureleffectivelpatientlresp
onses.”
c. “Nursesladministerslmedicationslwhilelevaluatingldrugleffectivenesslislalmedicallres
ponsibility.”
d. “Tolbestlassurelappropriatelresponse,lalpatient’slquestionslaboutldrugltherapylsho
uldlbelreferredltolthelpsychiatrist.”
ANS:l A
NursinglassessmentlandlanalN isRoS
ysU fldIaN
taGmTigBh.
tlsCuO
ggMestlthelneedlforlPRNlmedicationlaslpatientla
nxietylincreaseslorlpsychoticlsymptomslbecomelmorelacute.lThelnurselislthelhealth
teamlmemberlwholmakeslthisldetermination.lNurseslarelresponsiblelforlmonitoringldrugleffective
nesslaslwelllasladministeringlmedication.lNurseslshouldlassumelresponsibilitylforlteachinglpatien
tslaboutlthelsideleffectsloflmedications.lNurseslcannotlalterlprescribedldosagesloflmedicationslunle
ssltheylhavelprescriptivelprivileges.
DIF: Cognitivellevel:lAnalyzing
TOP:l Nursinglprocess:lAnalysislMSC:l ClientlNeeds:lSafe,lEffectivelCa
relEnvironment
8. Whenlconsideringlenvironmentallaspectsloflmilieulmanagement,lwhichlinterventionlhaslthelhig
hestlprioritylforlalclientladmittedlafterlalfailedlsuicidelattempt?
a. Sendinglthelclient’slnewlmedicationlprescriptionsltolthelpharmacy
b. Assigninglalstafflmemberltolone-on-onelobservationloflthelclient
c. Orientinglthelclientltolthelmilieu’slpubliclandlprivatelspaces
d. Havinglalllpotentiallyldangerouslitemslremovedlfromlthelclient’slbelongings
ANS:l B
Milieulmanagementlprovideslalproactivelapproachltolcare.lSafetyloverrideslalllotherldimension
sloflthelmilieu.lInitiationloflsuicidelprecautionslarelthelprioritylforlthislclient.lAlllthelremaininglo
ptionslarelappropriatelbutlnonelprotectlthelclientlfromlthelriskloflanotherlattemptltolself-
harmlasleffectivelylaslone-on-onelobservationlaslpartloflsuicidelprecautions.
DIF: Cognitivellevel:lAnalyzing TOP:l Nursinglprocess:lImplementation
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