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KELTNER’S PSYCHIATRIC NURSING, 9TH EDITION BY DEBBIE STEELE/ALL CHAPTERS 1-36
KELTNER’S PSYCHIATRIC NURSING, 9TH EDITION BY DEBBIE STEELE/ALL CHAPTERS 1-36
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TEST BANKKELTNER’S PSYCHIATRIC NURSING, 9TH EDITION BY
DEBBIE STEELE/ALL CHAPTERS 1-36
TEST BANK
.
,Chapter 01: Me, Meds, Milieu
Steele: Keltner’s Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed Nursing attendant asks a nursing recruiter for a description of nursing
practice in thepsychiatric setting. What is the Nursing attendant recruiter‘s best response?
a. “The Nursing attendant primarily serves in a supportive role to members of
the health caredelivery 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 hospital patients.”
ACCURATE ANSWER:-D
Reasoning:->>>Professional role overlap cannot be denied; however, nursing is unique in
its focus on and application of psychotherapeutic management. Neither the facility nor the
multidisciplinaryteam define the professional responsibilities of its members but rather
utilizes their unique skills to provide holistic care. Ideally, all team members support each
other and have functions within the team.
DIFFICULTY: Cognitive level: Analyzing TOP:- Nursing process: Implementation
MSC: Hospital patient Needs: Safe, Effective Care Environment
2. Which component of the nursing process will the Nursing attendant focus upon
to address theresponsibility to match individual hospital patient needs with
appropriate services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ACCURATE ANSWER:-C
Reasoning:->>>Proper assessment is critical for being able to determine the appropriate
level of servicesthat will provide optimal care while considering hospital patient input
and at the lowest cost.
Planning and implementation utilizes the assessment data to identify and execute actions
(treatment plan) that will provide appropriate care. Evaluation validates the effectiveness of
the treatment plan.
DIFFICULTY: Cognitive level: Applying TOP:- Nursing process: Assessment
MSC: Hospital patient Needs: Safe, Effective Care Environment
3. An adult diagnosed with paranoid schizophrenia frequently experiences auditory
hallucinations and walks about the unit, muttering. Which nursing action demonstrates the
Nursing attendant‘s understanding of effective psychotherapeutic management of this
hospital patient?
a. Discussing the disease process of schizophrenia with the hospital patient and
their domesticpartner
b. Minimizing contact between this hospital patient and other hospital patients to assure a stress-
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, free
milieu
c. Administering PRN medication when first observing the evidence that the
hospital patient may be hallucinating
d. Independently determining that behavior modification is appropriate to decrease
the hospital patient‘s paranoid thoughts
ACCURATE ANSWER:-A
Reasoning:->>>An understanding of psychopathology is the foundation on which the three
components of psychotherapeutic management rest; it facilitates therapeutic
communication and provides a basis for understanding psychopharmacology and milieu
management. Minimizing contact between the hospital 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 into
the plan of care by the care team.
DIFFICULTY: Cognitive level: Applying TOP:- Nursing process: Implementation
MSC: Hospital patient Needs: Safe, Effective Care Environment
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which
intervention is critical in assuring long-term, effective hospital patient 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
ACCURATE ANSWER:-D
Reasoning:->>>A critical element of psychotherapeutic management is the presence of a
therapeutic
Nursing attendant-hospital patient relationship. One-on-one time with nursing staff will help in
establishing this
connection. While the other options are appropriate and hospital patient centered, the
Nursing attendant-hospital patient relation is critical in the long-term delivery of quality
effective care to this hospital patient.
DIFFICULTY: Cognitive level: Applying TOP:- Nursing process: Implementation
MSC: Hospital patient Needs: Psychosocial Integrity
5. A hospital patient‘s haloperidol dosage was reduced 2 weeks ago to decrease side
effects. What assessment question demonstrates the Nursing attendant‘s understanding
of the resulting needs of the hospital patient?
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?”
ACCURATE ANSWER:-B
Reasoning:->>>It will be necessary for the Nursing attendant to assess for exacerbation of
the hospital patient‘s symptoms of psychosis as well as for a lessening of side effects.
Dosage decrease might lead to the returnor 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 assessment
questions, they are not directed at the current needs of the hospital patient which is the
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, identification of emerging psychotic behaviors.
DIFFICULTY: Cognitive level: Analyzing TOP:- Nursing process: Assessment
MSC: Hospital patient Needs: Physiologic Integrity
6. Which statement forms the foundation upon which a Nursing attendant should base the
implementationof psychotherapeutic management to the care of a hospital patient with
mental illness?
a. The Nursing attendant‘s role in hospital patient care is supported by the multidisciplinary team.
b. Omitting any one component will compromise the effectiveness of the treatment.
c. The most important element of psychotherapeutic management is drug therapy.
d. A therapeutic Nursing attendant-hospital patient relationship is the most important aspect of
treatment.
ACCURATE ANSWER:-B
Reasoning:->>>When one element is missing, treatment is usually compromised. No
single element is more important than the others; however, hospital patients‘ needs govern
the application of the components and permit judicious use. The remaining options identify
components of the psychotherapeutic management process.
DIFFICULTY: Cognitive level: Analyzing TOP:- Nursing process: Analysis
MSC: Hospital patient Needs: Safe, Effective Care Environment
7. Which statement most accurately describes a Nursing attendant‘s role regarding
psychopharmacology?
a. “You will need to frequently make decisions regarding the administration of PRN
medications to help the hospital patient manage anger.”
b. “It‘s a nursing responsibility to adjust a medication dose to assure effective
hospital patient responses.”
c. “Nursing attendants administers medications while evaluating drug effectiveness
is a medicalresponsibility.”
d. “To best assure appropriate response, a hospital patient’s questions about drug
therapyshould be referred to the psychiatrist.”
ACCURATE ANSWER:-A
Reasoning:->>>Nursing assessment and analysis of data might suggest the need for PRN
medication as hospital patient anxiety increases or psychotic symptoms become more acute.
The Nursing attendant is the healthteam member who makes this determination. Nursing
attendants are responsible for monitoring drug effectiveness as well as administering
medication. Nursing attendants should assume responsibility for teaching hospital patients
about the side effects of medications. Nursing attendants cannot alter prescribed dosages of
medications unless they have prescriptive privileges.
DIFFICULTY: Cognitive level: Analyzing TOP:- Nursing process: Analysis
MSC: Hospital patient Needs: Safe, Effective Care Environment
8. When considering environmental aspects of milieu management, which intervention has the
highest priority for a hospital patient admitted after a failed suicide attempt?
a. Sending the hospital patient‘s new medication prescriptions to the pharmacy
b. Assigning a staff member to one-on-one observation of the hospital patient
c. Orienting the hospital patient to the milieu‘s public and private spaces
d. Having all potentially dangerous items removed from the hospital patient‘s
belongings ACCURATE ANSWER:-B
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