PsychiatricfNursingf8thfEditionf TestfBan
k
Chapterf01:fMed,fMeds,fMilieu
Keltner:fPsychiatricfNursing,f8thfEdition
MULTIPLEfCHOICE
1. Afnewlyflicensedfasksfafnursingfrecruiterfforfafdescriptionfoffnursingfpracti
cefinfthefpsychiatricfsetting.fWhatfisfthefnursefrecruiter’sfbestfresponse?
a. “Thefnursefprimarilyfservesfinfafsupportivefroleftofmembersfoffthe
healthfcarefdeliveryfteam.”
b. “Thefmultidisciplinaryfapproachfeliminatesfthefneedftofclearlyfdefin
efthefresponsibilitiesfoffnursingfinfsuchfafsetting.”
c. “Nursingfactionsfarefidentifiedfbyfthefinstitutionfthatfdistinguishesfn
ursingffromfotherfmentalfhealthfprofessions.”
d. “Nursingfoffersfuniquefcontributionsftofthefpsychotherapeuticfmana
gementfoffpsychiatricfpatients.”
ANS:f D
Professionalfrolefoverlapfcannotfbefdenied;fhowever,fnursingfisfuniquefinfitsffocusfonfandfapplicati
onfoffpsychotherapeuticfmanagement.fNeitherftheffacilityfnorfthefmultidisciplinaryfteamfdefinefthef
professionalfresponsibilitiesfoffitsfmembersfbutfratherfutilizesftheirfuniquefskillsftofprovidefholisticf
care.fIdeally,fallfteamfmembersfsupportfeachfotherfandfhaveffunctionsfwithinfthefteam.
DIF: Cognitiveflevel:fAnalyzing
TOP:f Nursingfprocess:fImplementationfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
2. Whichfcomponentfoffthefnursingfprocessfwillfthefnurseffocusfuponftofaddressfthefresponsibility
ftofmatchfindividualfpatientfneedsfwithfappropriatefservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:f C
Properfassessmentfisfcriticalfforfbeingfableftofdeterminefthefappropriateflevelfoffservicesfthatfwillfp
rovidefoptimalfcarefwhilefconsideringfpatientfinputfandfatftheflowestfcost.fPlanningfandfimplement
ationfutilizesfthefassessmentfdataftofidentifyfandfexecutefactionsf(treatmentfplan)fthatfwillfprovidefa
ppropriatefcare.fEvaluationfvalidatesfthefeffectivenessfofftheftreatmentfplan.
DIF: Cognitiveflevel:fApplying
TOP:f Nursingfprocess:fAssessmentfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
3. Anfadultfdiagnosedfwithfparanoidfschizophreniaffrequentfexperiencesfauditoryfhallucinationsfa
ndfwalksfaboutfthefunit,fmuttering.fWhichfnursingfactionfdemonstratesfthefnurse’sfunderstandi
ngfoffeffectivefpsychotherapeuticfmanagementfoffthisfclient?
a. Discussingfthefdiseasefprocessfoffschizophreniafwithfthefclientfandftheirfdomest
ic
partner
, PsychiatricfNursingf8thfEditionf TestfBan
k
b. Minimizingfcontactfbetweenfthisfpatientfandfotherfpatientsftofassurefafstressffr
ee
milieu
c. AdministeringfPRNfmedicationfwhenffirstfobservingfthefevidencefthatfthefclie
ntfmayfbefhallucinating
d. Independentlyfdeterminingfthatfbehaviorfmodificationfisfappropriateftofdecreas
efthefclient’sfparanoidfthoughts
ANS:f A
Anfunderstandingfoffpsychopathologyfisftheffoundationfonfwhichfthefthreefcomponentsfoffpsychoth
erapeuticfmanagementfrest;fitffacilitatesftherapeuticfcommunicationfandfprovidesfafbasisfforfunderst
andingfpsychopharmacologyfandfmilieufmanagement.fMinimizingfcontactfbetweenfthefpatientfandfo
thersfandfadministeringfPRNfmedicationfindiscriminatelyfarefnontherapeuticfinterventions.fUsingfbe
haviorfmodificationftofdecreaseftheffrequencyfoffhallucinationsfwouldfneedftofbefincorporatedfintoft
hefplanfoffcarefbyfthefcarefteam.
DIF: Cognitiveflevel:fApplying
TOP:f Nursingfprocess:fImplementationfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
4. Anfadultfdiagnosedfwithfchronicfdepressionfisfhospitalizedfafterfafsuicidefattempt.fWhichfinterventi
onfisfcriticalfinfassuringflong-
term,feffectivefclientfcarefasfdescribedfbyfpsychotherapeuticfmanagement?
a. Involvementfinfgroupftherapies
b. Focusfoffclosefsupervisionfbyfthefunitfstaff
c. Maintainingfeffectivefcommunicationfwithfsupportfsyste
m
d. Frequentlyfscheduledfone-on-oneftimefwithfnursingfstaff
ANS:f D
Afcriticalfelementfoffpsychotherapeuticfmanagementfisfthefpresencefoffaftherapeuticfnurse-
patientfrelationship.fOne-on-
oneftimefwithfnursingfstafffwillfhelpfinfestablishingfthisfconnection.fWhilefthefotherfoptionsfarefap
propriatefandfclientfcentered,fthefnurse-clientfrelationfisfcriticalfinftheflong-
termfdeliveryfoffqualityfeffectivefcareftofthisfclient.
DIF: Cognitiveflevel:fApplying
TOP:f Nursingfprocess:fImplementationfMSC:f ClientfNeeds:fPsychosocialf
Integrity
5. Afpatient’sfhaloperidolfdosagefwasfreducedf2fweeksfagoftofdecreasefsidefeffects.fWhatfassessm
entfquestionfdemonstratesfthefnurse’sfunderstandingfoffthefresultingfneedsfoffthefclient?
a. “Willfyoufhavefanyfdifficultyfgettingfyourfprescriptionfrefilled?”
b. “Havefyoufbegunfexperiencingfanyfformsfoffhallucinations?”
c. “Whatfdofyoufexpectfwillfoccurfsincefthefdosagefhasfbeenfreduced?”
d. “WhatfcanfIfdoftofhelpfyoufmanagefthisfreductionfinfhaloperidolftherapy
?”
ANS:f B
Itfwillfbefnecessaryfforfthefnurseftofassessfforfexacerbationfoffthefpatient’sfsymptomsfoffpsychosisf
asfwellfasfforfaflesseningfoffsidefeffects.fDosagefdecreasefmightfleadftofthefreturnforfworseningfoff
positivefsymptomsfsuchfasfhallucinationsfandfdelusions,fandfnegativefsymptomsfsuchfasfbluntedfaf
fect,fsocialfwithdrawal,fandfpoorfgrooming.fWhilefthefotherfoptionsfmayfbefappropriatefassessmentf
questions,ftheyfarefnotfdirectedfatfthefcurrentfneedsfoffthefclient;fthefidentificationfoffemergingfpsy
,PsychiatricfNursingf8thfEditionf TestfBan
k
choticfbehaviors.
DIF: Cognitiveflevel:fAnalyzing TOP:f Nursingfprocess:fAssessment
, PsychiatricfNursingf8thfEditionf TestfBan
k
MSC:f ClientfNeeds:fPhysiologicfIntegrity
6. Whichfstatementfformsftheffoundationfuponfwhichfafnursefshouldfbasefthefimplementation
foffpsychotherapeuticfmanagementftofthefcarefoffafpatientfwithfmentalfillness?
a. Thefnurse’sfrolefinfclientfcarefisfsupportedfbyfthefmultidisciplinaryfteam.
b. Omittingfanyfonefcomponentfwillfcompromisefthefeffectivenessfofftheftreatment
.
c. Thefmostfimportantfelementfoffpsychotherapeuticfmanagementfisfdrugftherapy.
d. Aftherapeuticfnurse-
patientfrelationshipfisfthefmostfimportantfaspectfofftreatment.
ANS:f B
Whenfonefelementfisfmissing,ftreatmentfisfusuallyfcompromised.fNofsinglefelementfisfmorefimport
antfthanfthefothers;fhowever,fpatients’fneedsfgovernfthefapplicationfoffthefcomponentsfandfpermitfj
udiciousfuse.fThefremainingfoptionsfidentifyfcomponentsfoffthefpsychotherapeuticfmanagementfpro
cess.
DIF: Cognitiveflevel:fAnalyzing
TOP:f Nursingfprocess:fAnalysisfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
7. Whichfstatementfmostfaccuratelyfdescribesfafnurse’sfrolefregardingfpsychopharmacology?
a. “YoufwillfneedftoffrequentlyfmakefdecisionsfregardingfthefadministrationfoffPR
N
medicationsftofhelpfthefclientfmanagefanger.”
b. “It’sfafnursingfresponsibilityftofadjustfafmedicationfdoseftofassurefeffectivefpatie
nt
responses.”
c. “Nursesfadministersfmedicationsfwhilefevaluatingfdrugfeffectivenessfisfafmedical
responsibility.”
d. “Tofbestfassurefappropriatefresponse,fafpatient’sfquestionsfaboutfdrugftherapy
shouldfbefreferredftofthefpsychiatrist.”
ANS:f A
NursingfassessmentfandfanalysisfoffdatafmightfsuggestfthefneedfforfPRNfmedicationfasfpatientfanxiet
yfincreasesforfpsychoticfsymptomsfbecomefmorefacute.fThefnursefisfthefhealthfteamfmemberfwhofma
kesfthisfdetermination.fNursesfarefresponsiblefforfmonitoringfdrugfeffectivenessfasfwellfasfadministeri
ngfmedication.fNursesfshouldfassumefresponsibilityfforfteachingfpatientsfaboutfthefsidefeffectsfoffme
dications.fNursesfcannotfalterfprescribedfdosagesfoffmedicationsfunlessftheyfhavefprescriptivefprivileg
es.
DIF: Cognitiveflevel:fAnalyzing
TOP:f Nursingfprocess:fAnalysisfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
8. Whenfconsideringfenvironmentalfaspectsfoffmilieufmanagement,fwhichfinterventionfhasfthefhigh
estfpriorityfforfafclientfadmittedfafterfaffailedfsuicidefattempt?
a. Sendingfthefclient’sfnewfmedicationfprescriptionsftofthefpharmacy
b. Assigningfafstafffmemberftofone-on-onefobservationfoffthefclient
c. Orientingfthefclientftofthefmilieu’sfpublicfandfprivatefspaces
d. Havingfallfpotentiallyfdangerousfitemsfremovedffromfthefclient’sfbelonging
s
ANS:f B
k
Chapterf01:fMed,fMeds,fMilieu
Keltner:fPsychiatricfNursing,f8thfEdition
MULTIPLEfCHOICE
1. Afnewlyflicensedfasksfafnursingfrecruiterfforfafdescriptionfoffnursingfpracti
cefinfthefpsychiatricfsetting.fWhatfisfthefnursefrecruiter’sfbestfresponse?
a. “Thefnursefprimarilyfservesfinfafsupportivefroleftofmembersfoffthe
healthfcarefdeliveryfteam.”
b. “Thefmultidisciplinaryfapproachfeliminatesfthefneedftofclearlyfdefin
efthefresponsibilitiesfoffnursingfinfsuchfafsetting.”
c. “Nursingfactionsfarefidentifiedfbyfthefinstitutionfthatfdistinguishesfn
ursingffromfotherfmentalfhealthfprofessions.”
d. “Nursingfoffersfuniquefcontributionsftofthefpsychotherapeuticfmana
gementfoffpsychiatricfpatients.”
ANS:f D
Professionalfrolefoverlapfcannotfbefdenied;fhowever,fnursingfisfuniquefinfitsffocusfonfandfapplicati
onfoffpsychotherapeuticfmanagement.fNeitherftheffacilityfnorfthefmultidisciplinaryfteamfdefinefthef
professionalfresponsibilitiesfoffitsfmembersfbutfratherfutilizesftheirfuniquefskillsftofprovidefholisticf
care.fIdeally,fallfteamfmembersfsupportfeachfotherfandfhaveffunctionsfwithinfthefteam.
DIF: Cognitiveflevel:fAnalyzing
TOP:f Nursingfprocess:fImplementationfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
2. Whichfcomponentfoffthefnursingfprocessfwillfthefnurseffocusfuponftofaddressfthefresponsibility
ftofmatchfindividualfpatientfneedsfwithfappropriatefservices?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS:f C
Properfassessmentfisfcriticalfforfbeingfableftofdeterminefthefappropriateflevelfoffservicesfthatfwillfp
rovidefoptimalfcarefwhilefconsideringfpatientfinputfandfatftheflowestfcost.fPlanningfandfimplement
ationfutilizesfthefassessmentfdataftofidentifyfandfexecutefactionsf(treatmentfplan)fthatfwillfprovidefa
ppropriatefcare.fEvaluationfvalidatesfthefeffectivenessfofftheftreatmentfplan.
DIF: Cognitiveflevel:fApplying
TOP:f Nursingfprocess:fAssessmentfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
3. Anfadultfdiagnosedfwithfparanoidfschizophreniaffrequentfexperiencesfauditoryfhallucinationsfa
ndfwalksfaboutfthefunit,fmuttering.fWhichfnursingfactionfdemonstratesfthefnurse’sfunderstandi
ngfoffeffectivefpsychotherapeuticfmanagementfoffthisfclient?
a. Discussingfthefdiseasefprocessfoffschizophreniafwithfthefclientfandftheirfdomest
ic
partner
, PsychiatricfNursingf8thfEditionf TestfBan
k
b. Minimizingfcontactfbetweenfthisfpatientfandfotherfpatientsftofassurefafstressffr
ee
milieu
c. AdministeringfPRNfmedicationfwhenffirstfobservingfthefevidencefthatfthefclie
ntfmayfbefhallucinating
d. Independentlyfdeterminingfthatfbehaviorfmodificationfisfappropriateftofdecreas
efthefclient’sfparanoidfthoughts
ANS:f A
Anfunderstandingfoffpsychopathologyfisftheffoundationfonfwhichfthefthreefcomponentsfoffpsychoth
erapeuticfmanagementfrest;fitffacilitatesftherapeuticfcommunicationfandfprovidesfafbasisfforfunderst
andingfpsychopharmacologyfandfmilieufmanagement.fMinimizingfcontactfbetweenfthefpatientfandfo
thersfandfadministeringfPRNfmedicationfindiscriminatelyfarefnontherapeuticfinterventions.fUsingfbe
haviorfmodificationftofdecreaseftheffrequencyfoffhallucinationsfwouldfneedftofbefincorporatedfintoft
hefplanfoffcarefbyfthefcarefteam.
DIF: Cognitiveflevel:fApplying
TOP:f Nursingfprocess:fImplementationfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
4. Anfadultfdiagnosedfwithfchronicfdepressionfisfhospitalizedfafterfafsuicidefattempt.fWhichfinterventi
onfisfcriticalfinfassuringflong-
term,feffectivefclientfcarefasfdescribedfbyfpsychotherapeuticfmanagement?
a. Involvementfinfgroupftherapies
b. Focusfoffclosefsupervisionfbyfthefunitfstaff
c. Maintainingfeffectivefcommunicationfwithfsupportfsyste
m
d. Frequentlyfscheduledfone-on-oneftimefwithfnursingfstaff
ANS:f D
Afcriticalfelementfoffpsychotherapeuticfmanagementfisfthefpresencefoffaftherapeuticfnurse-
patientfrelationship.fOne-on-
oneftimefwithfnursingfstafffwillfhelpfinfestablishingfthisfconnection.fWhilefthefotherfoptionsfarefap
propriatefandfclientfcentered,fthefnurse-clientfrelationfisfcriticalfinftheflong-
termfdeliveryfoffqualityfeffectivefcareftofthisfclient.
DIF: Cognitiveflevel:fApplying
TOP:f Nursingfprocess:fImplementationfMSC:f ClientfNeeds:fPsychosocialf
Integrity
5. Afpatient’sfhaloperidolfdosagefwasfreducedf2fweeksfagoftofdecreasefsidefeffects.fWhatfassessm
entfquestionfdemonstratesfthefnurse’sfunderstandingfoffthefresultingfneedsfoffthefclient?
a. “Willfyoufhavefanyfdifficultyfgettingfyourfprescriptionfrefilled?”
b. “Havefyoufbegunfexperiencingfanyfformsfoffhallucinations?”
c. “Whatfdofyoufexpectfwillfoccurfsincefthefdosagefhasfbeenfreduced?”
d. “WhatfcanfIfdoftofhelpfyoufmanagefthisfreductionfinfhaloperidolftherapy
?”
ANS:f B
Itfwillfbefnecessaryfforfthefnurseftofassessfforfexacerbationfoffthefpatient’sfsymptomsfoffpsychosisf
asfwellfasfforfaflesseningfoffsidefeffects.fDosagefdecreasefmightfleadftofthefreturnforfworseningfoff
positivefsymptomsfsuchfasfhallucinationsfandfdelusions,fandfnegativefsymptomsfsuchfasfbluntedfaf
fect,fsocialfwithdrawal,fandfpoorfgrooming.fWhilefthefotherfoptionsfmayfbefappropriatefassessmentf
questions,ftheyfarefnotfdirectedfatfthefcurrentfneedsfoffthefclient;fthefidentificationfoffemergingfpsy
,PsychiatricfNursingf8thfEditionf TestfBan
k
choticfbehaviors.
DIF: Cognitiveflevel:fAnalyzing TOP:f Nursingfprocess:fAssessment
, PsychiatricfNursingf8thfEditionf TestfBan
k
MSC:f ClientfNeeds:fPhysiologicfIntegrity
6. Whichfstatementfformsftheffoundationfuponfwhichfafnursefshouldfbasefthefimplementation
foffpsychotherapeuticfmanagementftofthefcarefoffafpatientfwithfmentalfillness?
a. Thefnurse’sfrolefinfclientfcarefisfsupportedfbyfthefmultidisciplinaryfteam.
b. Omittingfanyfonefcomponentfwillfcompromisefthefeffectivenessfofftheftreatment
.
c. Thefmostfimportantfelementfoffpsychotherapeuticfmanagementfisfdrugftherapy.
d. Aftherapeuticfnurse-
patientfrelationshipfisfthefmostfimportantfaspectfofftreatment.
ANS:f B
Whenfonefelementfisfmissing,ftreatmentfisfusuallyfcompromised.fNofsinglefelementfisfmorefimport
antfthanfthefothers;fhowever,fpatients’fneedsfgovernfthefapplicationfoffthefcomponentsfandfpermitfj
udiciousfuse.fThefremainingfoptionsfidentifyfcomponentsfoffthefpsychotherapeuticfmanagementfpro
cess.
DIF: Cognitiveflevel:fAnalyzing
TOP:f Nursingfprocess:fAnalysisfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
7. Whichfstatementfmostfaccuratelyfdescribesfafnurse’sfrolefregardingfpsychopharmacology?
a. “YoufwillfneedftoffrequentlyfmakefdecisionsfregardingfthefadministrationfoffPR
N
medicationsftofhelpfthefclientfmanagefanger.”
b. “It’sfafnursingfresponsibilityftofadjustfafmedicationfdoseftofassurefeffectivefpatie
nt
responses.”
c. “Nursesfadministersfmedicationsfwhilefevaluatingfdrugfeffectivenessfisfafmedical
responsibility.”
d. “Tofbestfassurefappropriatefresponse,fafpatient’sfquestionsfaboutfdrugftherapy
shouldfbefreferredftofthefpsychiatrist.”
ANS:f A
NursingfassessmentfandfanalysisfoffdatafmightfsuggestfthefneedfforfPRNfmedicationfasfpatientfanxiet
yfincreasesforfpsychoticfsymptomsfbecomefmorefacute.fThefnursefisfthefhealthfteamfmemberfwhofma
kesfthisfdetermination.fNursesfarefresponsiblefforfmonitoringfdrugfeffectivenessfasfwellfasfadministeri
ngfmedication.fNursesfshouldfassumefresponsibilityfforfteachingfpatientsfaboutfthefsidefeffectsfoffme
dications.fNursesfcannotfalterfprescribedfdosagesfoffmedicationsfunlessftheyfhavefprescriptivefprivileg
es.
DIF: Cognitiveflevel:fAnalyzing
TOP:f Nursingfprocess:fAnalysisfMSC:f ClientfNeeds:fSafe,fEffectiv
efCarefEnvironment
8. Whenfconsideringfenvironmentalfaspectsfoffmilieufmanagement,fwhichfinterventionfhasfthefhigh
estfpriorityfforfafclientfadmittedfafterfaffailedfsuicidefattempt?
a. Sendingfthefclient’sfnewfmedicationfprescriptionsftofthefpharmacy
b. Assigningfafstafffmemberftofone-on-onefobservationfoffthefclient
c. Orientingfthefclientftofthefmilieu’sfpublicfandfprivatefspaces
d. Havingfallfpotentiallyfdangerousfitemsfremovedffromfthefclient’sfbelonging
s
ANS:f B
