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Keltner’s Psychiatric Nursing 9th Edition by
Debbie Steele ISBN-10 0323791964 ISBN-13
978-0323791960
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,Chapter 1: Med, Meds, Milieu
Keltner: Psychiatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly licensed asks a nursing recruiter for a description of nursing practice in the psychiatric setting
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.”
ANS: D
Professional role overlap cannot be denied; however, nursing is unique in its focus on and application o
management. Neither the facility nor the multidisciplinary team define the professional responsibilities
utilizes their unique skills to provide holistic care. Ideally, all team members support each other and ha
2. Which component of the nursing process will the nurse focus upon to address the responsibility to mat
with appropriate services?
a. Planning
b. Evaluation
c. Assessment
d. Implementation
ANS: C
Proper assessment is critical for being able to determine the appropriate level of services that will prov
considering patient input and at the lowest cost. Planning and implementation utilizes the assessment d
actions (treatment plan) that will provide appropriate care. Evaluation validates the effectiveness of the
, facilitates therapeutic communication and provides a basis for understanding psychopharmacology and
Minimizing contact between the patient and others and administering PRN medication indiscriminately
interventions. Using behavior modification to decrease the frequency of hallucinations would need to b
of care by the care team.
4. An adult diagnosed with chronic depression is hospitalized after a suicide attempt. Which intervention
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
ANS: D
A critical element of psychotherapeutic management is the presence of a therapeutic nurse-patient relat
with nursing staff will help in establishing this connection. While the other options are appropriate and
nurse-client relation is critical in the long-term delivery of quality effective care to this client.
, 5. A patient’s haloperidol dosage was reduced 2 weeks ago to decrease side effects. What assessment que
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?”
ANS: B
It will be necessary for the nurse to assess for exacerbation of the patient’s symptoms of psychosis as w
effects. Dosage decrease might lead to the return or worsening of positive symptoms such as hallucinat
negative symptoms such as blunted affect, social withdrawal, and poor grooming. While the other optio
assessment questions, they are not directed at the current needs of the client; the identification of emerg
6. Which statement forms the foundation upon which a nurse should base the implementation of psychoth
care of a patient with mental illness?
a. The nurse’s role in client 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 nurse-patient relationship is the most important aspect of treatment.
ANS: B
When one element is missing, treatment is usually compromised. No single element is more important
patients’ needs govern the application of the components and permit judicious use. The remaining optio
the psychotherapeutic management process.
7. Which statement most accurately describes a nurse’s role regarding psychopharmacology?
a. “You will need to frequently make decisions regarding the administration of PRN
medications to help the client manage anger.”
b. “It’s a nursing responsibility to adjust a medication dose to assure effective
patient responses.”
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