ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1. Question 1 — Chapter 8: Therapeutic Communication,
Effective Communication
Type: Conceptual recall
Stem: A nurse enters the room of a patient who says, “I
feel like no one understands me.” Which therapist
response is most therapeutic to promote further
communication?
Options:
A. “Everything will be fine; try to stay positive.”
B. “No one understands me either sometimes.”
C. “Tell me more about what you mean by that.”
D. “You shouldn’t feel that way; think about your family.”
Correct answer: C
Rationale — Correct: “Tell me more…” is an open-ended,
nonjudgmental prompt that encourages elaboration and fosters
therapeutic rapport. It aligns with techniques described for
,facilitating patient expression.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 8:
Therapeutic Communication, Effective Communication.)
Rationales — Incorrect:
A. Reassurance without exploration may minimize feelings and
shut down communication.
B. Self-disclosure by the nurse can shift focus away from the
patient and may be boundary-crossing.
D. Directive advice is judgmental and blocks expression.
NCLEX/HESI applicability: Demonstrates therapeutic
communication — a foundational psychosocial integrity skill
and therapeutic relationship competency.
Teaching Point: Use open-ended prompts to elicit patient
feelings and build rapport.
Mapping: Chapter 8 — Therapeutic Communication — Use of
open-ended questions.
2. Question 2 — Chapter 9: The Nurse–Patient Relationship,
Boundaries
Type: Application
Stem: A nurse caring for a long-term outpatient with
borderline personality disorder receives a friend request
on social media from the patient. The nurse should next:
Options:
A. Accept the request to maintain trust.
B. Ignore the request and do nothing.
, C. Discuss the request with the patient and explain
professional boundaries.
D. Block the patient immediately to protect privacy.
Correct answer: C
Rationale — Correct: Discussing the request acknowledges the
patient, clarifies professional boundaries, and maintains
therapeutic relationship integrity. This aligns with guidance on
boundary management.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 9: The
Nurse–Patient Relationship, Considerations for Effective
Communication and Relationships.)
Rationales — Incorrect:
A. Accepting blurs professional boundaries and risks dual
relationships.
B. Ignoring omits an opportunity to set clear expectations and
may harm trust.
D. Blocking is abrupt and may damage therapeutic rapport
without discussion.
NCLEX/HESI applicability: Related to legal/ethical boundaries,
professional conduct, and therapeutic relationship skills.
Teaching Point: Address boundary issues directly and
professionally.
Mapping: Chapter 9 — Nurse–Patient Relationship — Boundary
management.
, 3. Question 3 — Chapter 10: The Psychiatric–Mental Health
Nursing Process, Recovery-Oriented Psychiatric–Mental
Health Nursing Assessment
Type: Clinical scenario
Stem: During admission, a young adult reports hearing
voices telling them they are worthless and says they
recently started skipping medication. Which initial nursing
action is highest priority?
Options:
A. Provide education about medication adherence.
B. Assess immediate risk for self-harm or harm to others.
C. Schedule a family meeting for support.
D. Offer group therapy referral.
Correct answer: B
Rationale — Correct: Safety assessment (suicide/homicide risk)
is priority in the mental status and risk assessment when
auditory hallucinations and nonadherence are present.
Immediate risk determines subsequent interventions.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 10:
Recovery-Oriented Psychiatric–Mental Health Nursing
Assessment — Risk Assessment.)
Guideline: DSM-5-TR (2022) emphasizes risk assessment in
acute psychosis. Psychiatry Online
Rationales — Incorrect:
A. Education is important but secondary to immediate safety
assessment.
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1. Question 1 — Chapter 8: Therapeutic Communication,
Effective Communication
Type: Conceptual recall
Stem: A nurse enters the room of a patient who says, “I
feel like no one understands me.” Which therapist
response is most therapeutic to promote further
communication?
Options:
A. “Everything will be fine; try to stay positive.”
B. “No one understands me either sometimes.”
C. “Tell me more about what you mean by that.”
D. “You shouldn’t feel that way; think about your family.”
Correct answer: C
Rationale — Correct: “Tell me more…” is an open-ended,
nonjudgmental prompt that encourages elaboration and fosters
therapeutic rapport. It aligns with techniques described for
,facilitating patient expression.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 8:
Therapeutic Communication, Effective Communication.)
Rationales — Incorrect:
A. Reassurance without exploration may minimize feelings and
shut down communication.
B. Self-disclosure by the nurse can shift focus away from the
patient and may be boundary-crossing.
D. Directive advice is judgmental and blocks expression.
NCLEX/HESI applicability: Demonstrates therapeutic
communication — a foundational psychosocial integrity skill
and therapeutic relationship competency.
Teaching Point: Use open-ended prompts to elicit patient
feelings and build rapport.
Mapping: Chapter 8 — Therapeutic Communication — Use of
open-ended questions.
2. Question 2 — Chapter 9: The Nurse–Patient Relationship,
Boundaries
Type: Application
Stem: A nurse caring for a long-term outpatient with
borderline personality disorder receives a friend request
on social media from the patient. The nurse should next:
Options:
A. Accept the request to maintain trust.
B. Ignore the request and do nothing.
, C. Discuss the request with the patient and explain
professional boundaries.
D. Block the patient immediately to protect privacy.
Correct answer: C
Rationale — Correct: Discussing the request acknowledges the
patient, clarifies professional boundaries, and maintains
therapeutic relationship integrity. This aligns with guidance on
boundary management.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 9: The
Nurse–Patient Relationship, Considerations for Effective
Communication and Relationships.)
Rationales — Incorrect:
A. Accepting blurs professional boundaries and risks dual
relationships.
B. Ignoring omits an opportunity to set clear expectations and
may harm trust.
D. Blocking is abrupt and may damage therapeutic rapport
without discussion.
NCLEX/HESI applicability: Related to legal/ethical boundaries,
professional conduct, and therapeutic relationship skills.
Teaching Point: Address boundary issues directly and
professionally.
Mapping: Chapter 9 — Nurse–Patient Relationship — Boundary
management.
, 3. Question 3 — Chapter 10: The Psychiatric–Mental Health
Nursing Process, Recovery-Oriented Psychiatric–Mental
Health Nursing Assessment
Type: Clinical scenario
Stem: During admission, a young adult reports hearing
voices telling them they are worthless and says they
recently started skipping medication. Which initial nursing
action is highest priority?
Options:
A. Provide education about medication adherence.
B. Assess immediate risk for self-harm or harm to others.
C. Schedule a family meeting for support.
D. Offer group therapy referral.
Correct answer: B
Rationale — Correct: Safety assessment (suicide/homicide risk)
is priority in the mental status and risk assessment when
auditory hallucinations and nonadherence are present.
Immediate risk determines subsequent interventions.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 10:
Recovery-Oriented Psychiatric–Mental Health Nursing
Assessment — Risk Assessment.)
Guideline: DSM-5-TR (2022) emphasizes risk assessment in
acute psychosis. Psychiatry Online
Rationales — Incorrect:
A. Education is important but secondary to immediate safety
assessment.
