ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter 1: Mental Health and Mental Disorders — Stigma
& Recovery
Type: Conceptual recall
Stem: A 28-year-old man with schizophrenia says he avoids
telling coworkers about his diagnosis because he fears being
judged and losing opportunities. Which nursing statement best
addresses stigma and promotes recovery?
Options:
A. “If you tell them carefully, they’ll probably accept you.”
B. “You should hide your diagnosis at work to avoid problems.”
C. “Many people face stigma; let’s talk about strategies that
protect your rights and support recovery.”
D. “Don’t worry — people often forget about diagnosis quickly.”
Correct answer: C
,Rationale — Correct: Option C acknowledges stigma, validates
experience, and offers collaborative problem-solving consistent
with recovery-oriented nursing. Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 1: Mental Health and Mental
Disorders — Fighting Stigma and Promoting Recovery. (Also
aligns with SAMHSA TIP 57, 2014 on trauma-informed,
recovery-oriented care.)
Rationales — Incorrect:
A. Overly optimistic and prescriptive; doesn’t acknowledge
stigma or teach coping/advocacy.
B. Encourages secrecy that may undermine rights and social
supports.
D. Minimizes the client’s concern and may block therapeutic
rapport.
NCLEX/HESI applicability: Addresses psychosocial integrity and
therapeutic communication; relevant to NCLEX Client Needs:
Psychosocial Integrity — Coping/Grief.
Teaching Point: Validate stigma experiences and co-create
recovery strategies.
Mapping: Chapter 1 — Fighting Stigma and Promoting Recovery
— Key Concept: Addressing stigma; Recovery-oriented nursing.
2 — Chapter 8: Therapeutic Communication — Verbal &
Nonverbal Skills
,Type: Application
Stem: During an admission interview, a nurse notes the patient
keeps glancing at the door and speaking in short, guarded
sentences. Which therapeutic communication technique should
the nurse use first?
Options:
A. Confront the patient about avoidance behaviors.
B. Mirror nonverbal cues and gently invite elaboration: “You
look uneasy — what’s on your mind?”
C. Offer immediate advice: “You should try to relax.”
D. Change the subject to a neutral topic to reduce anxiety.
Correct answer: B
Rationale — Correct: Mirroring and an open invitation
acknowledge nonverbal cues and encourage expression,
building rapport. Essentials, Chapter 8: Therapeutic
Communication — Communication Skills.
Rationales — Incorrect:
A. Confrontation early may increase defensiveness.
C. Giving advice prematurely is nontherapeutic and patronizing.
D. Changing subject avoids addressing the patient’s concern.
NCLEX/HESI applicability: Promotes safe, therapeutic
communication and relationship-building (Psychosocial
Integrity).
Teaching Point: Attend to nonverbal cues and invite
exploration.
, Mapping: Chapter 8 — Therapeutic Communication — Key
Concept: Attending/mirroring.
3 — Chapter 9: The Nurse–Patient Relationship — Boundaries
& Professionalism
Type: Conceptual recall
Stem: A patient gifts the nurse a small handmade item after
discharge. Which action aligns with professional boundaries?
Options:
A. Accept and display it publicly on the unit shelf.
B. Refuse the gift and tell the patient it’s inappropriate.
C. Accept a small, token gift, document it, and assess intent.
D. Accept and solicit other gifts from the patient’s family.
Correct answer: C
Rationale — Correct: Small tokens may be accepted when
exploring intent and documenting is required; this maintains
professional boundaries. Essentials, Chapter 9: The Nurse–
Patient Relationship — Professional Boundaries.
Rationales — Incorrect:
A. Displaying publicly may blur boundaries and privacy.
B. Refusal without discussion may harm rapport.
D. Soliciting gifts is unethical and boundary-crossing.
NCLEX/HESI applicability: Ethics and therapeutic relationships
are key to safe, effective care (Safe and Effective Care
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter 1: Mental Health and Mental Disorders — Stigma
& Recovery
Type: Conceptual recall
Stem: A 28-year-old man with schizophrenia says he avoids
telling coworkers about his diagnosis because he fears being
judged and losing opportunities. Which nursing statement best
addresses stigma and promotes recovery?
Options:
A. “If you tell them carefully, they’ll probably accept you.”
B. “You should hide your diagnosis at work to avoid problems.”
C. “Many people face stigma; let’s talk about strategies that
protect your rights and support recovery.”
D. “Don’t worry — people often forget about diagnosis quickly.”
Correct answer: C
,Rationale — Correct: Option C acknowledges stigma, validates
experience, and offers collaborative problem-solving consistent
with recovery-oriented nursing. Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 1: Mental Health and Mental
Disorders — Fighting Stigma and Promoting Recovery. (Also
aligns with SAMHSA TIP 57, 2014 on trauma-informed,
recovery-oriented care.)
Rationales — Incorrect:
A. Overly optimistic and prescriptive; doesn’t acknowledge
stigma or teach coping/advocacy.
B. Encourages secrecy that may undermine rights and social
supports.
D. Minimizes the client’s concern and may block therapeutic
rapport.
NCLEX/HESI applicability: Addresses psychosocial integrity and
therapeutic communication; relevant to NCLEX Client Needs:
Psychosocial Integrity — Coping/Grief.
Teaching Point: Validate stigma experiences and co-create
recovery strategies.
Mapping: Chapter 1 — Fighting Stigma and Promoting Recovery
— Key Concept: Addressing stigma; Recovery-oriented nursing.
2 — Chapter 8: Therapeutic Communication — Verbal &
Nonverbal Skills
,Type: Application
Stem: During an admission interview, a nurse notes the patient
keeps glancing at the door and speaking in short, guarded
sentences. Which therapeutic communication technique should
the nurse use first?
Options:
A. Confront the patient about avoidance behaviors.
B. Mirror nonverbal cues and gently invite elaboration: “You
look uneasy — what’s on your mind?”
C. Offer immediate advice: “You should try to relax.”
D. Change the subject to a neutral topic to reduce anxiety.
Correct answer: B
Rationale — Correct: Mirroring and an open invitation
acknowledge nonverbal cues and encourage expression,
building rapport. Essentials, Chapter 8: Therapeutic
Communication — Communication Skills.
Rationales — Incorrect:
A. Confrontation early may increase defensiveness.
C. Giving advice prematurely is nontherapeutic and patronizing.
D. Changing subject avoids addressing the patient’s concern.
NCLEX/HESI applicability: Promotes safe, therapeutic
communication and relationship-building (Psychosocial
Integrity).
Teaching Point: Attend to nonverbal cues and invite
exploration.
, Mapping: Chapter 8 — Therapeutic Communication — Key
Concept: Attending/mirroring.
3 — Chapter 9: The Nurse–Patient Relationship — Boundaries
& Professionalism
Type: Conceptual recall
Stem: A patient gifts the nurse a small handmade item after
discharge. Which action aligns with professional boundaries?
Options:
A. Accept and display it publicly on the unit shelf.
B. Refuse the gift and tell the patient it’s inappropriate.
C. Accept a small, token gift, document it, and assess intent.
D. Accept and solicit other gifts from the patient’s family.
Correct answer: C
Rationale — Correct: Small tokens may be accepted when
exploring intent and documenting is required; this maintains
professional boundaries. Essentials, Chapter 9: The Nurse–
Patient Relationship — Professional Boundaries.
Rationales — Incorrect:
A. Displaying publicly may blur boundaries and privacy.
B. Refusal without discussion may harm rapport.
D. Soliciting gifts is unethical and boundary-crossing.
NCLEX/HESI applicability: Ethics and therapeutic relationships
are key to safe, effective care (Safe and Effective Care
