TEST BANK - Keltners Psychiatric Nursing,
9th Edition (Steele),
Chapters 1 - 36 | All Chapters Complete
,
,Chapter,01:,Med,,Meds,,Milieu
Keltner:,Psychiatric,Nursing,,8th,Edition
MULTIPLE,CHOICE
1. A,newly,licensed,asks,a,nursing,recruiter,for,a,description,of,nursing,practice,in,the,psyc
hiatric,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.‖
ANSWER:, D
Professional,role,overlap,cannot,be,denied;,however,,nursing,is,unique,in,its,focus,on,and,applicat
ion,of,psychotherapeutic,management.,Neither,the,facility,nor,the,multidisciplinary,team,define,t
he,professional,responsibilities,of,its,members,but,rather,utilizes,their,unique,skills,to,provide,hol
istic,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,Ca
re,Environment
2. Which,component,of,the,nursing,process,will,the,nurse,focus,upon,to,address,the,resp
onsibility,to,match,individual,patient, needs,with,appropriate,services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANSWER:, C
Proper,assessment,is,critical,for,being,able,to,determine,the,appropriate,level,of,services,that,will,p
rovide,optimal,care,while,considering,patient,input,and,at,the,lowest,cost.,Planning,and,implemen
tation,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,Ca
re,Environment
3. An,adult,diagnosed,with,paranoid,schizophrenia,frequent,experiences,auditory,hallucinations,an
d,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
ANSWER:, A
An,understanding,of,psychopathology,is,the,foundation,on,which,the,three,components,of,psychoth
erapeutic,management,rest;,it,facilitates,therapeutic,communication,and,provides,a,basis,for,underst
anding,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,in
to,the,plan,of,care,by,the,care,team.
DIF: Cognitive,level:,Applying
TOP:, Nursing,process:,Implementation,MSC:, Client,Needs:,Safe,,Effective,Ca
re,Environment
4. An,adult,diagnosed,with,chronic,depression,is,hospitalized,after,a,suicide,attempt.,Which,inte
rvention,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
ANSWER:, 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,ap
propriate,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,Inte
grity
5. A,patient‘s,haloperidol,dosage,was,reduced,2,weeks,ago,to,decrease,side,effects.,What,asses
sment,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?‖
ANSWER:, 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,assess
ment,questions,,they,are,not,directed,at,the,current,needs,of,the,client;,the,identification,of,emergin
g,psychotic,behaviors.
DIF: Cognitive,level:,Analyzing
TOP:, Nursing,process:,Assessment,MSC:, Client,Needs:,Physiologic,Integr
ity
