Chapter 20: Introduction to Milieu Management

Chapter 20: Introduction to Milieu Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During orientation the clinical nurse leader tells a novice nurse, “You will be involved in purposeful creation of corrective learning experiences for all patients so as to provide a healing atmosphere.” The clinical nurse leader is explaining aspects of:

a.	balance.
b.	limit-setting.
c.	a therapeutic environment.
d.	establishing behavioral norms.

 

 

ANS:  C

A therapeutic environment requires creation of corrective learning experiences to promote a therapeutic atmosphere. Limit-setting, balance, and norms are individual elements of the therapeutic environment and are answers that are too narrow.

 

DIF:    Cognitive level: Understanding        REF:   pp. 212-213

TOP:   Nursing process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment

 

2. Four nurses describe their unit environments. Which description can most clearly be identified as therapeutic?

a.	“My unit uses behavior modification to enhance patients’ social skills.”
b.	“My unit allows patients to test new behaviors in a secure environment.”
c.	“My unit helps patients deal with childhood issues by providing a safe setting.”
d.	“My unit allows patients to deal with personal issues without interpersonal stressors.”

 

 

ANS:  B

The unit described in the correct answer provides a broad therapeutic focus for providing corrective experiences that helps patients recover. The distracters are too narrow in their therapeutic scope.

 

DIF:    Cognitive level: Applying                REF:   p. 214             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Safe, Effective Care Environment

 

3. Which nursing action best supports maintenance of a therapeutic environment?

a.	Creating therapeutic relationships with patients
b.	Providing purposeful structured activities
c.	Maintaining patient records and care plans
d.	Administering medication

 

 

ANS:  A

A therapeutic environment requires nurses to be active and willing to engage in therapeutic relationships with patients. These relationships support patients’ development of coping and problem-solving skills. Maintaining records, administering medications, and providing activities are important in the therapeutic environment, but to a lesser extent than meaningful nurse–patient interactions.

 

DIF:    Cognitive level: Applying                REF:   p. 214

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

4. While nurses are engaged in shift change report, one patient becomes loud and aggressive. This patient verbally harasses and frightens another patient. Which element of the therapeutic environment has been jeopardized?

a.	Norms
b.	Safety
c.	Balance
d.	Structure

 

 

ANS:  B

Psychologic safety is violated when one patient is allowed to harass another. Staff must set limits to protect the vulnerable patient. Norms, balance, and structure refer to other elements of the environment.

 

DIF:    Cognitive level: Applying                REF:   p. 215             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Psychosocial Integrity