TEST BANK For Keltners Psychiatric Nursing, 9th Edition By Debbie Steele, Verified Chapters 1 - 36, Fully Covered Complete Newest Version

,Chapter 01: Me, Meds, Milieu
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Steele: Keltner’s Psychiatric Nursing, 9th Edition
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MULTIPLE CHOICE NJNJ




1. A newly licensed nurse asks a nursing recruiter for a description of nursing
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NJNJ practice in the 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
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care NJNJ



delivery team.‖ NJNJ



b. ―The multidisciplinary approach eliminates the need to clearly define the
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responsibilities of nursing in such a setting.‖ NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ



c. ―Nursing actions are identified by the institution that distinguishes
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nursing fromNJNJ NJNJ



other mental health professions.‖ NJNJ NJNJ NJNJ



d. ―Nursing offers unique contributions to the psychotherapeutic management
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of NJNJ



psychiatric patients.‖ NJNJ




ANS: N J N J D
Professional role overlap cannot be denied; however, nursing is unique in its focus
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on and application of psychotherapeutic management. Neither the facility nor the
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multidisciplinary team define the professional responsibilities of its members but
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rather utilizes their unique skills to provide holistic care. Ideally, all team
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members support each other and have functions within the team.
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DIF: Cognitive level: Analyzing TOP: Nursing process: NJNJ NJNJ N J N J NJNJ



Implementation MSC:
NJNJ Client Needs: Safe, Effective Care Environment
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2. Which component of the nursing process will the nurse focus upon to
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address the responsibility to match individual patient needs with
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appropriate services?
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a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: N J N J C
Proper assessment is critical for being able to determine the appropriate level of
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services that will provide optimal care while considering patient input and at the
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lowest cost. Planning and implementation utilizes the assessment data to identify
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and execute actions (treatment plan) that will provide appropriate care. Evaluation
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validates the effectiveness of the treatment plan.
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DIF: Cognitive level: Applying NJNJ NJNJ TOP: N J N J Nursing process: NJNJ

, Assessment MSC:
NJNJ NJNJ N J N J Client Needs: Safe, Effective Care Environment
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3. An adult diagnosed with paranoid schizophrenia frequently experiences auditory
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hallucinations and walks about the unit, muttering. Which nursing action
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demonstrates the nurse‘s understanding of effective psychotherapeutic
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management of this client?
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a. Discussing the disease process of schizophrenia with the client and their
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domestic NJNJ



partner
b. Minimizing contact between this patient and other patients to assure a
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stress-freeNJNJ



milieu
c. Administering PRN medication when first observing the evidence that the NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ



client NJNJ



may be hallucinating NJNJ NJNJ



d. Independently determining that behavior modification is appropriate to NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ NJNJ



decrease NJNJ



the client‘s paranoid thoughts
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ANS: N J N J A
An understanding of psychopathology is the foundation on which the three
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components of psychotherapeutic management rest; it facilitates therapeutic
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communication and provides a basis for understanding psychopharmacology and milieu
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management. Minimizing contact between the patient and others and administering
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PRN medication indiscriminately are nontherapeutic interventions. Using behavior
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modification to decrease the frequency of hallucinations would need to be
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incorporated into the plan of care by the care team.
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DIF: Cognitive level: Applying TOP: Nursing process: NJNJ NJNJ N J N J NJNJ



Implementation MSC:
NJNJ Client Needs: Safe, Effective Care Environment
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4. An adult diagnosed with chronic depression is hospitalized after a suicide
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attempt. Which intervention is critical in assuring long-term, effective client
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care as described by psychotherapeutic management?
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a. Involvement in group therapies NJNJ NJNJ NJNJ



b. Focus of close supervision by the unit staff
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c. Maintaining effective communication with support NJNJ NJNJ NJNJ NJNJ



system NJNJ



d. Frequently scheduled one-on-one time with nursing NJNJ NJNJ NJNJ NJNJ NJNJ



staff NJNJ




ANS: N J N J D
A critical element of psychotherapeutic management is the presence of a therapeutic
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nurse-patient relationship. One-on-one time with nursing staff will help in establishing
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this connection. While the other options are appropriate and client centered, the
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nurse-client relation is critical in the long-term delivery of quality effective care
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to this client.
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DIF: Cognitive level: Applying TOP: Nursing process: NJNJ NJNJ N J N J NJNJ



Implementation MSC:
NJNJ Client Needs: Psychosocial Integrity NJNJ N J N J NJNJ NJNJ NJNJ




5. A patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
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, effects. What assessment question demonstrates the nurse‘s understanding of the
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resulting needs of the client?
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a. ―Will you have any difficulty getting your prescription refilled?‖
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b. ―Have you begun experiencing any forms of hallucinations?‖
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c. ―What do you expect will occur since the dosage has been reduced?‖
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d. ―What can I do to help you manage this reduction in haloperidol
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therapy?‖ NJNJ




ANS: N J N J B
It will be necessary for the nurse to assess for exacerbation of the patient‘s
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symptoms of psychosis as well as for a lessening of side effects. Dosage
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decrease might lead to the return or worsening of positive symptoms such as
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hallucinations and delusions, and negative symptoms such as blunted affect, social
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withdrawal, and poor grooming. While the other options may be appropriate
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assessment questions, they are not directed at the current needs of the client which
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is the identification of emerging psychotic behaviors.
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DIF: Cognitive level: Analyzing TOP: Nursing process: NJNJ NJNJ N J N J NJNJ



Assessment MSC:
NJNJ Client Needs: Physiologic Integrity
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