TEST BANK - Keltners Psychiatric Nursing, 9th
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m Edition (Steele),
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Chapters 1 - 36 | All Chapters Complete
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,
,Chapter 01: Med, Meds, Milieu
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Keltner: Psychiatric Nursing, 8th Edition
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MULTIPLE CHOICE m
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
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psychiatric setting. What is the nurse recruiter‘s best response?
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a. ―The nurse primarily serves in a supportive role to members of the health care
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delivery team.‖ m
b. ―The multidisciplinary approach eliminates the need to clearly define the
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responsibilities of nursing in such a setting.‖ m m m m m m
c. ―Nursing actions are identified by the institution that distinguishes nursing from
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other mental health professions.‖ m m m
d. ―Nursing offers unique contributions to the psychotherapeutic management of
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psychiatric patients.‖ m
ANSWER: D m
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
m m m m m m m m m m m m m m
application of psychotherapeutic management. Neither the facility nor the multidisciplinary
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team define the professional responsibilities of its members but rather utilizes their unique skills
m m m m m m m m m m m m m m
to provide holistic care. Ideally, all team members support each other and have functions within
m m m m m m m m m m m m m m m
mthe team. m
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation m m m m m
MSC: Client Needs: Safe, Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to address the
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responsibility to match individual patient needs with appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C m
Proper assessment is critical for being able to determine the appropriate level of services that will
m m m m m m m m m m m m m m m
provide optimal care while considering patient input and at the lowest cost. Planning and
m m m m m m m m m m m m m m
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
m m m m m m m m m m m m m
will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
m m m m m m m m m m m m
DIF: Cognitive level: Applying TOP: Nursing process: Assessment m m m m m
MSC: Client Needs: Safe, Effective Care Environment
m m m m m m m
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
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and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s
m m m m m m m m m m m m
understanding of effective psychotherapeutic management of this client?
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a. Discussing the disease process of schizophrenia with the client and their domestic
m m m m m m m m m m m
partner
b. Minimizing contact between this patient and other patients to assure a stress free m m m m m m m m m m m m
milieu
c. Administering PRN medication when first observing the evidence that the client m m m m m m m m m m
, may be hallucinating
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d. Independently determining that behavior modification is appropriate to decrease m m m m m m m m
the client‘s paranoid thoughts
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ANSWER: A m
An understanding of psychopathology is the foundation on which the three components of
m m m m m m m m m m m m
psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
m m m m m m m m m m m
for understanding psychopharmacology and milieu management. Minimizing contact between
m m m m m m m m m
the patient and others and administering PRN medication indiscriminately are nontherapeutic
m m m m m m m m m m m
interventions. Using behavior modification to decrease the frequency of hallucinations would
m m m m m m m m m m m
need to be incorporated into the plan of care by the care team.
m m m m m m m m m m m m m
DIF: Cognitive level: Applying TOP: Nursing process: Implementation m m m m m
MSC: Client Needs: Safe, Effective Care Environment
m m m m m m m
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
m m m m m m m m m m m m
intervention is critical in assuring long-term, effective client care as described by
m m m m m m m m m m m m
psychotherapeutic management?
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a. Involvement in group therapies m m m
b. Focus of close supervision by the unit staff m m m m m m m
c. Maintaining effective communication with support system m m m m m
d. Frequently scheduled one-on-one time with nursing staff m m m m m m
ANSWER: D m
A critical element of psychotherapeutic management is the presence of a therapeutic
m m m m m m m m m m m
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this
m m m m m m m m m m m
connection. While the other options are appropriate and client centered, the nurse-client relation
m m m m m m m m m m m m m
is critical in the long-term delivery of quality effective care to this client.
m m m m m m m m m m m m m
DIF: Cognitive level: Applying TOP: Nursing process: Implementation m m m m m
MSC: Client Needs: Psychosocial Integrity
m m m m m
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
m m m m m m m m m m m m m
assessment question demonstrates the nurse‘s understanding of the resulting needs of the
m m m m m m m m m m m m
client?
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a. ―Will you have any difficulty getting your prescription refilled?‖
m m m m m m m m
b. ―Have you begun experiencing any forms of hallucinations?‖
m m m m m m m
c. ―What do you expect will occur since the dosage has been reduced?‖
m m m m m m m m m m m
d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
m m m m m m m m m m m m
ANSWER: B m
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
m m m m m m m m m m m m m m m
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or
m m m m m m m m m m m m m m m m m m
worsening of positive symptoms such as hallucinations and delusions, and negative symptoms
m m m m m m m m m m m m
such as blunted affect, social withdrawal, and poor grooming. While the other options may be
m m m m m m m m m m m m m m m
appropriate assessment questions, they are not directed at the current needs ofthe client; the
m m m m m m m m m m m m m m m
identification of emerging psychotic behaviors.
m m m m m
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment m m m m m
MSC: Client Needs: Physiologic Integrity
m m m m m
m m m m m m
m Edition (Steele),
m m
Chapters 1 - 36 | All Chapters Complete
m m m m m m m m
,
,Chapter 01: Med, Meds, Milieu
m m m m
Keltner: Psychiatric Nursing, 8th Edition
m m m m
MULTIPLE CHOICE m
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the
m m m m m m m m m m m m m m
psychiatric setting. What is the nurse recruiter‘s best response?
m m m m m m m m m
a. ―The nurse primarily serves in a supportive role to members of the health care
m m m m m m m m m m m m m
delivery team.‖ m
b. ―The multidisciplinary approach eliminates the need to clearly define the
m m m m m m m m m
responsibilities of nursing in such a setting.‖ m m m m m m
c. ―Nursing actions are identified by the institution that distinguishes nursing from
m m m m m m m m m m
other mental health professions.‖ m m m
d. ―Nursing offers unique contributions to the psychotherapeutic management of
m m m m m m m m
psychiatric patients.‖ m
ANSWER: D m
Professional role overlap cannot be denied; however, nursing is unique in its focus on and
m m m m m m m m m m m m m m
application of psychotherapeutic management. Neither the facility nor the multidisciplinary
m m m m m m m m m m
team define the professional responsibilities of its members but rather utilizes their unique skills
m m m m m m m m m m m m m m
to provide holistic care. Ideally, all team members support each other and have functions within
m m m m m m m m m m m m m m m
mthe team. m
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation m m m m m
MSC: Client Needs: Safe, Effective Care Environment
m m m m m m m
2. Which component of the nursing process will the nurse focus upon to address the
m m m m m m m m m m m m m
responsibility to match individual patient needs with appropriate services?
m m m m m m m m m
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER: C m
Proper assessment is critical for being able to determine the appropriate level of services that will
m m m m m m m m m m m m m m m
provide optimal care while considering patient input and at the lowest cost. Planning and
m m m m m m m m m m m m m m
implementation utilizes the assessment data to identify and execute actions (treatment plan) that
m m m m m m m m m m m m m
will provide appropriate care. Evaluation validates the effectiveness of the treatment plan.
m m m m m m m m m m m m
DIF: Cognitive level: Applying TOP: Nursing process: Assessment m m m m m
MSC: Client Needs: Safe, Effective Care Environment
m m m m m m m
3. An adult diagnosed with paranoid schizophrenia frequent experiences auditory hallucinations
m m m m m m m m m
and walks about the unit, muttering. Which nursing action demonstrates the nurse‘s
m m m m m m m m m m m m
understanding of effective psychotherapeutic management of this client?
m m m m m m m m
a. Discussing the disease process of schizophrenia with the client and their domestic
m m m m m m m m m m m
partner
b. Minimizing contact between this patient and other patients to assure a stress free m m m m m m m m m m m m
milieu
c. Administering PRN medication when first observing the evidence that the client m m m m m m m m m m
, may be hallucinating
m m
d. Independently determining that behavior modification is appropriate to decrease m m m m m m m m
the client‘s paranoid thoughts
m m m
ANSWER: A m
An understanding of psychopathology is the foundation on which the three components of
m m m m m m m m m m m m
psychotherapeutic management rest; it facilitates therapeutic communication and provides abasis
m m m m m m m m m m m
for understanding psychopharmacology and milieu management. Minimizing contact between
m m m m m m m m m
the patient and others and administering PRN medication indiscriminately are nontherapeutic
m m m m m m m m m m m
interventions. Using behavior modification to decrease the frequency of hallucinations would
m m m m m m m m m m m
need to be incorporated into the plan of care by the care team.
m m m m m m m m m m m m m
DIF: Cognitive level: Applying TOP: Nursing process: Implementation m m m m m
MSC: Client Needs: Safe, Effective Care Environment
m m m m m m m
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
m m m m m m m m m m m m
intervention is critical in assuring long-term, effective client care as described by
m m m m m m m m m m m m
psychotherapeutic management?
m m
a. Involvement in group therapies m m m
b. Focus of close supervision by the unit staff m m m m m m m
c. Maintaining effective communication with support system m m m m m
d. Frequently scheduled one-on-one time with nursing staff m m m m m m
ANSWER: D m
A critical element of psychotherapeutic management is the presence of a therapeutic
m m m m m m m m m m m
nurse-patient relationship. One-on-one time with nursing staff will help in establishing this
m m m m m m m m m m m
connection. While the other options are appropriate and client centered, the nurse-client relation
m m m m m m m m m m m m m
is critical in the long-term delivery of quality effective care to this client.
m m m m m m m m m m m m m
DIF: Cognitive level: Applying TOP: Nursing process: Implementation m m m m m
MSC: Client Needs: Psychosocial Integrity
m m m m m
5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What
m m m m m m m m m m m m m
assessment question demonstrates the nurse‘s understanding of the resulting needs of the
m m m m m m m m m m m m
client?
m
a. ―Will you have any difficulty getting your prescription refilled?‖
m m m m m m m m
b. ―Have you begun experiencing any forms of hallucinations?‖
m m m m m m m
c. ―What do you expect will occur since the dosage has been reduced?‖
m m m m m m m m m m m
d. ―What can I do to help you manage this reduction in haloperidol therapy?‖
m m m m m m m m m m m m
ANSWER: B m
It will be necessary for the nurse to assess for exacerbation of the patient‘s symptoms of
m m m m m m m m m m m m m m m
psychosis as well as for a lessening of side effects. Dosage decrease might lead to the return or
m m m m m m m m m m m m m m m m m m
worsening of positive symptoms such as hallucinations and delusions, and negative symptoms
m m m m m m m m m m m m
such as blunted affect, social withdrawal, and poor grooming. While the other options may be
m m m m m m m m m m m m m m m
appropriate assessment questions, they are not directed at the current needs ofthe client; the
m m m m m m m m m m m m m m m
identification of emerging psychotic behaviors.
m m m m m
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment m m m m m
MSC: Client Needs: Physiologic Integrity
m m m m m
