ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter & Subtopic: Chapter 1 — Foundations of
Psychiatric Nursing: Therapeutic Relationship, Boundaries
Type: Conceptual recall
Stem: A nurse begins working with a new inpatient who
frequently discloses very personal family details and requests
the nurse's personal phone number. Which nursing response
best reflects appropriate professional boundaries?
Options:
A. Give the patient your phone number and encourage them to
call if distressed.
B. Explain that you cannot share personal contact information
but offer to arrange additional therapeutic sessions.
C. Tell the patient you will exchange social media contacts to
stay connected.
D. Ignore the request and change topic to the patient's
medication schedule.
,Correct Answer: B
Rationale — Correct: Explaining boundary limits while offering
therapeutic alternatives maintains professionalism and patient
support, consistent with establishing a therapeutic relationship.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 1:
Therapeutic Relationship and Boundaries).
Rationales — Incorrect:
A. Giving personal contact breaches professional boundaries
and risks dual relationships.
C. Exchanging social media also risks boundary violations and
confidentiality breaches.
D. Ignoring the request without addressing boundary concerns
misses a therapeutic teaching opportunity.
NCLEX/HESI applicability: Tests therapeutic communication and
professional boundaries—key to Safe and Effective Care
Environment and Psychosocial Integrity.
Teaching Point: Maintain clear professional boundaries while
providing therapeutic alternatives.
2 — Chapter & Subtopic: Chapter 2 — Therapeutic
Communication: Active Listening & Validation
Type: Application
Stem: A patient with major depressive disorder says, “I feel
worthless and like I’m a burden.” Which nurse response most
effectively uses validation?
Options:
,A. “You shouldn’t feel that way—things will get better.”
B. “I understand this is painful; tell me more about what makes
you feel like a burden.”
C. “Everyone feels low sometimes; try to think positive.”
D. “You need to stop thinking like that and take your meds.”
Correct Answer: B
Rationale — Correct: Validation acknowledges feelings and
invites elaboration, fostering trust and therapeutic
communication. (Essentials..., Chapter 2: Therapeutic
Communication — Active Listening).
Rationales — Incorrect:
A. Minimizes feelings and offers false reassurance.
C. Minimizes and redirects without exploring emotions.
D. Judgmental and prescriptive, undermining rapport.
NCLEX/HESI applicability: Assesses therapeutic communication
skills and patient assessment—Psychosocial Integrity.
Teaching Point: Validate feelings and encourage patient
expression.
3 — Chapter & Subtopic: Chapter 3 — Milieu Therapy:
Structure & Safety
Type: Clinical scenario
Stem: On a psychiatric unit, a recently admitted patient with
mania is pacing and interrupting group activities. Which nursing
action best supports milieu therapy and safety?
Options:
, A. Immediately discharge the patient for noncompliance.
B. Escort the patient to a quieter area and offer a brief,
structured one-to-one activity.
C. Ignore the behavior to avoid confronting the patient.
D. Tell group members to continue and not to engage with the
patient.
Correct Answer: B
Rationale — Correct: Redirecting to a quieter structured activity
maintains safety and the therapeutic milieu while meeting the
patient's needs. (Essentials..., Chapter 3: Milieu Therapy —
Structure & Safety).
Rationales — Incorrect:
A. Discharge is unsafe and inappropriate for acute mania.
C. Ignoring may escalate risk and disrupt the milieu.
D. Excluding the patient without intervention fails to provide
therapeutic structure.
NCLEX/HESI applicability: Safety-focused intervention and
milieu management—Safe and Effective Care Environment.
Teaching Point: Use structured redirection to preserve safety
and therapeutic environment.
4 — Chapter & Subtopic: Chapter 4 — Recovery Model &
Trauma-Informed Care: Principles of Recovery-Oriented Care
Type: Conceptual recall
Stem: Which statement best reflects a recovery-oriented
approach to psychiatric care?
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter & Subtopic: Chapter 1 — Foundations of
Psychiatric Nursing: Therapeutic Relationship, Boundaries
Type: Conceptual recall
Stem: A nurse begins working with a new inpatient who
frequently discloses very personal family details and requests
the nurse's personal phone number. Which nursing response
best reflects appropriate professional boundaries?
Options:
A. Give the patient your phone number and encourage them to
call if distressed.
B. Explain that you cannot share personal contact information
but offer to arrange additional therapeutic sessions.
C. Tell the patient you will exchange social media contacts to
stay connected.
D. Ignore the request and change topic to the patient's
medication schedule.
,Correct Answer: B
Rationale — Correct: Explaining boundary limits while offering
therapeutic alternatives maintains professionalism and patient
support, consistent with establishing a therapeutic relationship.
(Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 1:
Therapeutic Relationship and Boundaries).
Rationales — Incorrect:
A. Giving personal contact breaches professional boundaries
and risks dual relationships.
C. Exchanging social media also risks boundary violations and
confidentiality breaches.
D. Ignoring the request without addressing boundary concerns
misses a therapeutic teaching opportunity.
NCLEX/HESI applicability: Tests therapeutic communication and
professional boundaries—key to Safe and Effective Care
Environment and Psychosocial Integrity.
Teaching Point: Maintain clear professional boundaries while
providing therapeutic alternatives.
2 — Chapter & Subtopic: Chapter 2 — Therapeutic
Communication: Active Listening & Validation
Type: Application
Stem: A patient with major depressive disorder says, “I feel
worthless and like I’m a burden.” Which nurse response most
effectively uses validation?
Options:
,A. “You shouldn’t feel that way—things will get better.”
B. “I understand this is painful; tell me more about what makes
you feel like a burden.”
C. “Everyone feels low sometimes; try to think positive.”
D. “You need to stop thinking like that and take your meds.”
Correct Answer: B
Rationale — Correct: Validation acknowledges feelings and
invites elaboration, fostering trust and therapeutic
communication. (Essentials..., Chapter 2: Therapeutic
Communication — Active Listening).
Rationales — Incorrect:
A. Minimizes feelings and offers false reassurance.
C. Minimizes and redirects without exploring emotions.
D. Judgmental and prescriptive, undermining rapport.
NCLEX/HESI applicability: Assesses therapeutic communication
skills and patient assessment—Psychosocial Integrity.
Teaching Point: Validate feelings and encourage patient
expression.
3 — Chapter & Subtopic: Chapter 3 — Milieu Therapy:
Structure & Safety
Type: Clinical scenario
Stem: On a psychiatric unit, a recently admitted patient with
mania is pacing and interrupting group activities. Which nursing
action best supports milieu therapy and safety?
Options:
, A. Immediately discharge the patient for noncompliance.
B. Escort the patient to a quieter area and offer a brief,
structured one-to-one activity.
C. Ignore the behavior to avoid confronting the patient.
D. Tell group members to continue and not to engage with the
patient.
Correct Answer: B
Rationale — Correct: Redirecting to a quieter structured activity
maintains safety and the therapeutic milieu while meeting the
patient's needs. (Essentials..., Chapter 3: Milieu Therapy —
Structure & Safety).
Rationales — Incorrect:
A. Discharge is unsafe and inappropriate for acute mania.
C. Ignoring may escalate risk and disrupt the milieu.
D. Excluding the patient without intervention fails to provide
therapeutic structure.
NCLEX/HESI applicability: Safety-focused intervention and
milieu management—Safe and Effective Care Environment.
Teaching Point: Use structured redirection to preserve safety
and therapeutic environment.
4 — Chapter & Subtopic: Chapter 4 — Recovery Model &
Trauma-Informed Care: Principles of Recovery-Oriented Care
Type: Conceptual recall
Stem: Which statement best reflects a recovery-oriented
approach to psychiatric care?
