ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1–40 Items
Question 1 — Chapter 8: Therapeutic Communication,
Therapeutic Communication Skills
Type: Conceptual recall
Stem: A nurse begins an initial interview with a newly admitted
client who is tearful and says, “I don’t know why I’m even here.”
Which therapeutic response best encourages further expression
and builds rapport?
Options:
A. “You’ll feel better after medication; try to relax.”
B. “Tell me more about what brought you here today.”
C. “Don’t worry — the staff here know what they’re doing.”
D. “Everyone feels that way sometimes; it will pass.”
Correct Answer: B
,Rationale — Correct: Asking “Tell me more…” is an open,
nonjudgmental prompt that encourages the client to elaborate
and supports therapeutic communication. It conveys interest
and invites narrative, a core skill in building rapport.
Rationales — Incorrect:
A. Directing to medication minimizes feelings and blocks
exploration.
C. Reassurance without exploration dismisses current distress
and can hinder trust.
D. Normalizing in a dismissive way may minimize the client’s
unique experience.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and psychosocial integrity—critical for
establishing a therapeutic nurse–patient relationship.
Teaching Point: Use open, nonjudgmental prompts to
encourage expression.
Mapping: Chapter 8 — Therapeutic Communication — Use of
open prompts to elicit client narrative. → NCLEX: Psychosocial
Integrity — Therapeutic Communication.
Question 2 — Chapter 9: Nurse–Patient Relationship,
Establishing Boundaries
Type: Application
Stem: A client in outpatient therapy gifts the nurse a handmade
bracelet and asks the nurse to wear it. Which is the best nursing
action?
,Options:
A. Accept the bracelet and wear it during all future visits.
B. Politely decline and explain the unit policy prohibiting gifts.
C. Accept the bracelet then give it to a coworker.
D. Accept the bracelet and donate it later without telling the
client.
Correct Answer: B
Rationale — Correct: Politely declining while explaining policy
maintains professional boundaries and transparency, preserving
trust and ethical standards. Chapter guidance emphasizes
boundary clarity.
Rationales — Incorrect:
A. Wearing the gift may blur professional boundaries and create
dual-relationship issues.
C. Accepting then giving away is dishonest and harms
therapeutic trust.
D. Secretly accepting and discarding is deceptive and unethical.
NCLEX/HESI applicability: Addresses legal/ethical practice,
professional boundaries, and therapeutic relationship—NCLEX
safety/ethics domains.
Teaching Point: Maintain boundaries and use clear, honest
explanations.
Mapping: Chapter 9 — Nurse–Patient Relationship — Boundary
management and ethics. → NCLEX: Safe and Effective Care
Environment — Legal/Ethical.
, Question 3 — Chapter 10: Assessment, Mental Status Exam
(MSE)
Type: Clinical scenario
Stem: During a mental status exam a client speaks slowly, with
limited spontaneous movement, shows blunted affect, and
reports low mood for 3 weeks. Which MSE finding best
supports distinguishing major depressive disorder from normal
bereavement?
Options:
A. Presence of guilt and pervasive hopelessness affecting
function.
B. Intact insight and preserved interest in daily activities.
C. Recent loss of a loved one within the last week.
D. Mood improves when talking about the deceased.
Correct Answer: A
Rationale — Correct: Intense guilt and pervasive hopelessness
with functional impairment are characteristic of major
depressive disorder; DSM-5-TR emphasizes symptom severity
and functional decline to distinguish from normal bereavement.
Rationales — Incorrect:
B. Preserved interest and intact insight suggest less severe
pathology.
C. Recent loss alone suggests bereavement; timing and other
symptoms matter.
D. Mood improving when discussing the deceased suggests
normal grief rather than persistent depressive disorder.
NCLEX/HESI applicability: Links psychiatric assessment to
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1–40 Items
Question 1 — Chapter 8: Therapeutic Communication,
Therapeutic Communication Skills
Type: Conceptual recall
Stem: A nurse begins an initial interview with a newly admitted
client who is tearful and says, “I don’t know why I’m even here.”
Which therapeutic response best encourages further expression
and builds rapport?
Options:
A. “You’ll feel better after medication; try to relax.”
B. “Tell me more about what brought you here today.”
C. “Don’t worry — the staff here know what they’re doing.”
D. “Everyone feels that way sometimes; it will pass.”
Correct Answer: B
,Rationale — Correct: Asking “Tell me more…” is an open,
nonjudgmental prompt that encourages the client to elaborate
and supports therapeutic communication. It conveys interest
and invites narrative, a core skill in building rapport.
Rationales — Incorrect:
A. Directing to medication minimizes feelings and blocks
exploration.
C. Reassurance without exploration dismisses current distress
and can hinder trust.
D. Normalizing in a dismissive way may minimize the client’s
unique experience.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and psychosocial integrity—critical for
establishing a therapeutic nurse–patient relationship.
Teaching Point: Use open, nonjudgmental prompts to
encourage expression.
Mapping: Chapter 8 — Therapeutic Communication — Use of
open prompts to elicit client narrative. → NCLEX: Psychosocial
Integrity — Therapeutic Communication.
Question 2 — Chapter 9: Nurse–Patient Relationship,
Establishing Boundaries
Type: Application
Stem: A client in outpatient therapy gifts the nurse a handmade
bracelet and asks the nurse to wear it. Which is the best nursing
action?
,Options:
A. Accept the bracelet and wear it during all future visits.
B. Politely decline and explain the unit policy prohibiting gifts.
C. Accept the bracelet then give it to a coworker.
D. Accept the bracelet and donate it later without telling the
client.
Correct Answer: B
Rationale — Correct: Politely declining while explaining policy
maintains professional boundaries and transparency, preserving
trust and ethical standards. Chapter guidance emphasizes
boundary clarity.
Rationales — Incorrect:
A. Wearing the gift may blur professional boundaries and create
dual-relationship issues.
C. Accepting then giving away is dishonest and harms
therapeutic trust.
D. Secretly accepting and discarding is deceptive and unethical.
NCLEX/HESI applicability: Addresses legal/ethical practice,
professional boundaries, and therapeutic relationship—NCLEX
safety/ethics domains.
Teaching Point: Maintain boundaries and use clear, honest
explanations.
Mapping: Chapter 9 — Nurse–Patient Relationship — Boundary
management and ethics. → NCLEX: Safe and Effective Care
Environment — Legal/Ethical.
, Question 3 — Chapter 10: Assessment, Mental Status Exam
(MSE)
Type: Clinical scenario
Stem: During a mental status exam a client speaks slowly, with
limited spontaneous movement, shows blunted affect, and
reports low mood for 3 weeks. Which MSE finding best
supports distinguishing major depressive disorder from normal
bereavement?
Options:
A. Presence of guilt and pervasive hopelessness affecting
function.
B. Intact insight and preserved interest in daily activities.
C. Recent loss of a loved one within the last week.
D. Mood improves when talking about the deceased.
Correct Answer: A
Rationale — Correct: Intense guilt and pervasive hopelessness
with functional impairment are characteristic of major
depressive disorder; DSM-5-TR emphasizes symptom severity
and functional decline to distinguish from normal bereavement.
Rationales — Incorrect:
B. Preserved interest and intact insight suggest less severe
pathology.
C. Recent loss alone suggests bereavement; timing and other
symptoms matter.
D. Mood improving when discussing the deceased suggests
normal grief rather than persistent depressive disorder.
NCLEX/HESI applicability: Links psychiatric assessment to
