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