ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1. Question 1 — Chapter 1: Mental Health and Mental
Disorders: Fighting Stigma and Promoting Recovery
Type: Conceptual recall
Stem: A newly hired psychiatric nurse is asked how stigma
most commonly affects persons with mental illness. Which
statement best describes stigma’s primary impact on
recovery?
Options:
A. It primarily increases medication adherence because
patients want to avoid labels.
B. It often reduces help-seeking and social support,
delaying recovery.
C. It mainly affects only institutionalized patients, not
those in the community.
D. It has no measurable impact on employment or housing
,opportunities.
Correct answer: B
Rationale — Correct: Stigma reduces help-seeking and
social support and is associated with delayed treatment
and poorer psychosocial outcomes, which impede
recovery. (Essentials of Psychiatric Nursing, 3rd Ed. —
Chapter 1: Mental Health and Mental Disorders: Fighting
Stigma and Promoting Recovery.) Guideline: WHO Mental
Health Action considerations (2013).
Rationales — Incorrect:
A. Incorrect — stigma more often reduces—not
increases—treatment engagement.
C. Incorrect — stigma affects both community and
institutionalized individuals.
D. Incorrect — stigma negatively affects employment and
housing opportunities.
NCLEX/HESI applicability: Tests psychosocial integrity and
therapeutic communication knowledge about barriers to
care.
Teaching Point: Stigma reduces help-seeking and social
support, harming recovery.
Mapping & Alignment: Chapter 1 — Mental Health and
Mental Disorders: Fighting Stigma and Promoting Recovery
— Key concept: Impact of stigma on help-seeking and
recovery.
,2. Question 2 — Chapter 8: Therapeutic Communication
Type: Application
Stem: A 30-year-old patient with major depressive
disorder says, “I feel hopeless and worthless.” Which nurse
response is the most therapeutic?
Options:
A. “You shouldn’t feel that way — look at all you have.”
B. “Tell me more about what makes you feel hopeless.”
C. “Everyone feels like that sometimes; snap out of it.”
D. “You must take your meds; that will fix things.”
Correct answer: B
Rationale — Correct: Open-ended, empathic prompts
(e.g., “Tell me more…”) encourage exploration, validate
feelings, and foster therapeutic rapport per
communication principles. (Essentials, Ch. 8 — Therapeutic
Communication.)
Rationales — Incorrect:
A. Incorrect — minimizes feelings and is judgmental.
C. Incorrect — dismissive and nontherapeutic.
D. Incorrect — prescriptive and ignores emotional content.
NCLEX/HESI applicability: Assesses therapeutic
communication skills and psychosocial integrity.
Teaching Point: Use open, empathic prompts to explore
patient feelings.
Mapping & Alignment: Chapter 8 — Therapeutic
Communication — Key concept: Open-ended, empathic
responses.
, 3. Question 3 — Chapter 9: The Nurse–Patient Relationship
Type: Clinical scenario**
Stem: A patient with borderline personality disorder
frequently asks the nurse for extra privileges and becomes
angry when denied. Which nurse action demonstrates
appropriate boundary management?
Options:
A. Give the patient the privileges to avoid conflict.
B. Clearly explain unit rules and apply them consistently.
C. Share personal contact information to build trust.
D. Ignore the behavior and hope it diminishes.
Correct answer: B
Rationale — Correct: Consistent limits and clear
communication maintain therapeutic boundaries and
safety while modeling appropriate interpersonal behavior.
(Essentials, Ch. 9 — The Nurse–Patient Relationship.)
Rationales — Incorrect:
A. Incorrect — reinforces maladaptive behavior and
violates boundaries.
C. Incorrect — breaches professional boundaries.
D. Incorrect — ignoring escalates unpredictability and risk.
NCLEX/HESI applicability: Relates to safe, effective care
environment (professional boundaries) and therapeutic
relationships.
Teaching Point: Maintain consistent limits and clear
explanation of rules.
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1. Question 1 — Chapter 1: Mental Health and Mental
Disorders: Fighting Stigma and Promoting Recovery
Type: Conceptual recall
Stem: A newly hired psychiatric nurse is asked how stigma
most commonly affects persons with mental illness. Which
statement best describes stigma’s primary impact on
recovery?
Options:
A. It primarily increases medication adherence because
patients want to avoid labels.
B. It often reduces help-seeking and social support,
delaying recovery.
C. It mainly affects only institutionalized patients, not
those in the community.
D. It has no measurable impact on employment or housing
,opportunities.
Correct answer: B
Rationale — Correct: Stigma reduces help-seeking and
social support and is associated with delayed treatment
and poorer psychosocial outcomes, which impede
recovery. (Essentials of Psychiatric Nursing, 3rd Ed. —
Chapter 1: Mental Health and Mental Disorders: Fighting
Stigma and Promoting Recovery.) Guideline: WHO Mental
Health Action considerations (2013).
Rationales — Incorrect:
A. Incorrect — stigma more often reduces—not
increases—treatment engagement.
C. Incorrect — stigma affects both community and
institutionalized individuals.
D. Incorrect — stigma negatively affects employment and
housing opportunities.
NCLEX/HESI applicability: Tests psychosocial integrity and
therapeutic communication knowledge about barriers to
care.
Teaching Point: Stigma reduces help-seeking and social
support, harming recovery.
Mapping & Alignment: Chapter 1 — Mental Health and
Mental Disorders: Fighting Stigma and Promoting Recovery
— Key concept: Impact of stigma on help-seeking and
recovery.
,2. Question 2 — Chapter 8: Therapeutic Communication
Type: Application
Stem: A 30-year-old patient with major depressive
disorder says, “I feel hopeless and worthless.” Which nurse
response is the most therapeutic?
Options:
A. “You shouldn’t feel that way — look at all you have.”
B. “Tell me more about what makes you feel hopeless.”
C. “Everyone feels like that sometimes; snap out of it.”
D. “You must take your meds; that will fix things.”
Correct answer: B
Rationale — Correct: Open-ended, empathic prompts
(e.g., “Tell me more…”) encourage exploration, validate
feelings, and foster therapeutic rapport per
communication principles. (Essentials, Ch. 8 — Therapeutic
Communication.)
Rationales — Incorrect:
A. Incorrect — minimizes feelings and is judgmental.
C. Incorrect — dismissive and nontherapeutic.
D. Incorrect — prescriptive and ignores emotional content.
NCLEX/HESI applicability: Assesses therapeutic
communication skills and psychosocial integrity.
Teaching Point: Use open, empathic prompts to explore
patient feelings.
Mapping & Alignment: Chapter 8 — Therapeutic
Communication — Key concept: Open-ended, empathic
responses.
, 3. Question 3 — Chapter 9: The Nurse–Patient Relationship
Type: Clinical scenario**
Stem: A patient with borderline personality disorder
frequently asks the nurse for extra privileges and becomes
angry when denied. Which nurse action demonstrates
appropriate boundary management?
Options:
A. Give the patient the privileges to avoid conflict.
B. Clearly explain unit rules and apply them consistently.
C. Share personal contact information to build trust.
D. Ignore the behavior and hope it diminishes.
Correct answer: B
Rationale — Correct: Consistent limits and clear
communication maintain therapeutic boundaries and
safety while modeling appropriate interpersonal behavior.
(Essentials, Ch. 9 — The Nurse–Patient Relationship.)
Rationales — Incorrect:
A. Incorrect — reinforces maladaptive behavior and
violates boundaries.
C. Incorrect — breaches professional boundaries.
D. Incorrect — ignoring escalates unpredictability and risk.
NCLEX/HESI applicability: Relates to safe, effective care
environment (professional boundaries) and therapeutic
relationships.
Teaching Point: Maintain consistent limits and clear
explanation of rules.
