Chapter_01.bnk
MULTIPLE CHOICE
1.A newly licensed nurse asks a nursing recruiter for a description of
nursing practice in the psychiatric 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."
ANS: d
Professional role overlap cannot be denied; however, nursing is unique
in its focus on and application of psychotherapeutic management.
Neither the facility nor the multidisciplinary team 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.
PTS: 1
DIF: Cognitive level: Analyzing
TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2.Which component of the nursing process will the nurse focus upon to
address the responsibility to match individual patient needs 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 provide optimal care while considering 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.
PTS: 1
DIF: Cognitive level: Applying
TOP: Nursing process: Assessment
MSC: Client 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 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
ANS: a
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 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.
PTS: 1
DIF: Cognitive level: Applying
,TOP: Nursing process: Implementation
MSC: Client 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 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 relationship. One-on-one time with nursing
staff will help in establishing this connection. While the other options
are appropriate and client centered, the nurse-client relation is critical in
the long-term delivery of quality effective care to this client.
PTS: 1
DIF: Cognitive level: Applying
TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
5. A patient's haloperidol dosage was reduced 2 weeks ago to decrease
side effects. What assessment 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?"
ANS: 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 assessment questions, they are not
directed at the current needs of the client which is the identification of
emerging psychotic behaviors.
PTS: 1
DIF: Cognitive level: Analyzing
TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity
6. Which statement forms the foundation upon which a nurse should
base the implementation of psychotherapeutic management to the 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 than the others; however, patients'
needs govern the application of the components and permit judicious
use. The remaining options identify components of the
psychotherapeutic management process.
PTS: 1
DIF: Cognitive level: Analyzing
TOP: Nursing process: Analysis
MSC: Client Needs: Safe, Effective Care Environment
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."
MULTIPLE CHOICE
1.A newly licensed nurse asks a nursing recruiter for a description of
nursing practice in the psychiatric 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."
ANS: d
Professional role overlap cannot be denied; however, nursing is unique
in its focus on and application of psychotherapeutic management.
Neither the facility nor the multidisciplinary team 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.
PTS: 1
DIF: Cognitive level: Analyzing
TOP: Nursing process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2.Which component of the nursing process will the nurse focus upon to
address the responsibility to match individual patient needs 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 provide optimal care while considering 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.
PTS: 1
DIF: Cognitive level: Applying
TOP: Nursing process: Assessment
MSC: Client 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 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
ANS: a
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 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.
PTS: 1
DIF: Cognitive level: Applying
,TOP: Nursing process: Implementation
MSC: Client 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 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 relationship. One-on-one time with nursing
staff will help in establishing this connection. While the other options
are appropriate and client centered, the nurse-client relation is critical in
the long-term delivery of quality effective care to this client.
PTS: 1
DIF: Cognitive level: Applying
TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
5. A patient's haloperidol dosage was reduced 2 weeks ago to decrease
side effects. What assessment 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?"
ANS: 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 assessment questions, they are not
directed at the current needs of the client which is the identification of
emerging psychotic behaviors.
PTS: 1
DIF: Cognitive level: Analyzing
TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity
6. Which statement forms the foundation upon which a nurse should
base the implementation of psychotherapeutic management to the 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 than the others; however, patients'
needs govern the application of the components and permit judicious
use. The remaining options identify components of the
psychotherapeutic management process.
PTS: 1
DIF: Cognitive level: Analyzing
TOP: Nursing process: Analysis
MSC: Client Needs: Safe, Effective Care Environment
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."
