ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter & Subtopic: Chapter 8: Therapeutic
Communication, Therapeutic Communication
Type: Therapeutic communication | Stem: A 22-year-old client
with newly diagnosed major depressive disorder sits quietly and
says, “I feel like a failure.” The nurse’s best therapeutic response
is:
Options:
A. “You shouldn’t talk like that — you must be doing something
right.”
B. “What makes you say you’re a failure?”
C. “Everyone feels that way sometimes; try to think positively.”
D. “Tell me more about why you think you’re a failure.”
Correct Answer: D
Rationale — Correct: Option D uses an open, nonjudgmental
prompt that encourages exploration of feelings, fostering
,therapeutic rapport and assessment of mood/thought content.
This aligns with therapeutic communication skills described in
Boyd & Luebbert. Cite: Essentials of Psychiatric Nursing, 3rd Ed.
— Chapter 8: Therapeutic Communication.
Rationales — Incorrect:
A. Minimizes and judges the client; blocks communication.
B. May sound challenging and provoke defensiveness rather
than exploration.
C. Offers premature reassurance and minimizes the client’s
experience.
NCLEX/HESI applicability: Tests therapeutic communication and
psychosocial integrity (communication with clients experiencing
mood disorders).
Teaching Point: Use open-ended, nonjudgmental prompts to
explore emotional content.
Mapping: Chapter 8 — Therapeutic Communication — Use of
open-ended prompts; Key Concept: therapeutic communication
skills.
2 — Chapter & Subtopic: Chapter 9: The Nurse–Patient
Relationship, Nurse–Patient Relationship
Type: Conceptual recall | Stem: Which phase of the nurse–
patient relationship is characterized by establishing rapport,
clarifying expectations, and setting boundaries?
Options:
A. Working phase
,B. Termination phase
C. Orientation (introductory) phase
D. Transference phase
Correct Answer: C
Rationale — Correct: The orientation phase is when rapport,
roles, expectations, and initial boundaries are set—foundational
for therapeutic relationships. Cite: Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 9: The Nurse–Patient Relationship.
Rationales — Incorrect:
A. Working phase focuses on interventions and problem solving.
B. Termination phase focuses on closure and summarizing gains.
D. Transference is a psychodynamic phenomenon, not a
relationship phase.
NCLEX/HESI applicability: Assesses professional role and
therapeutic relationship competencies in psychosocial integrity.
Teaching Point: Set clear roles, expectations, and boundaries
during orientation.
Mapping: Chapter 9 — The Nurse–Patient Relationship —
Phases of relationship; Key Concept: orientation phase tasks.
3 — Chapter & Subtopic: Chapter 11: Pharmacology, Dietary
Supplements, and Biologic Interventions — Antipsychotic
Monitoring
Type: Application | Stem: A client started on haloperidol
reports stiffness, drooling, and a stiff neck 5 days after initiation.
Which nursing action is most appropriate first?
, Options:
A. Reassure the client that these are expected and will resolve.
B. Hold the medication and notify the prescriber for possible
acute dystonia treatment (e.g., diphenhydramine or
benztropine).
C. Check the Abnormal Involuntary Movement Scale (AIMS) and
document mild changes.
D. Encourage fluids and ambulation; continue the current dose.
Correct Answer: B
Rationale — Correct: Sudden muscle rigidity and
oculogyric/neck dystonia suggest acute dystonic reaction—an
EPS emergency; immediate medication hold and
anticholinergic/antihistamine administration is indicated. Cite:
Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 11:
Pharmacology... (Antipsychotic monitoring); guideline: DSM-5-
TR (2022) description of antipsychotic side effects.
Rationales — Incorrect:
A. Dangerous — minimizes an urgent side effect.
C. AIMS targets tardive dyskinesia; acute dystonia needs
immediate treatment.
D. Continued dosing risks worsening dystonia and airway
compromise.
NCLEX/HESI applicability: Tests safe medication administration,
recognition of adverse effects, and timely reporting
(Physiological Integrity: Pharmacological Therapies).
Teaching Point: Treat acute dystonia immediately — hold med
and give anticholinergic/antihistamine.
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter & Subtopic: Chapter 8: Therapeutic
Communication, Therapeutic Communication
Type: Therapeutic communication | Stem: A 22-year-old client
with newly diagnosed major depressive disorder sits quietly and
says, “I feel like a failure.” The nurse’s best therapeutic response
is:
Options:
A. “You shouldn’t talk like that — you must be doing something
right.”
B. “What makes you say you’re a failure?”
C. “Everyone feels that way sometimes; try to think positively.”
D. “Tell me more about why you think you’re a failure.”
Correct Answer: D
Rationale — Correct: Option D uses an open, nonjudgmental
prompt that encourages exploration of feelings, fostering
,therapeutic rapport and assessment of mood/thought content.
This aligns with therapeutic communication skills described in
Boyd & Luebbert. Cite: Essentials of Psychiatric Nursing, 3rd Ed.
— Chapter 8: Therapeutic Communication.
Rationales — Incorrect:
A. Minimizes and judges the client; blocks communication.
B. May sound challenging and provoke defensiveness rather
than exploration.
C. Offers premature reassurance and minimizes the client’s
experience.
NCLEX/HESI applicability: Tests therapeutic communication and
psychosocial integrity (communication with clients experiencing
mood disorders).
Teaching Point: Use open-ended, nonjudgmental prompts to
explore emotional content.
Mapping: Chapter 8 — Therapeutic Communication — Use of
open-ended prompts; Key Concept: therapeutic communication
skills.
2 — Chapter & Subtopic: Chapter 9: The Nurse–Patient
Relationship, Nurse–Patient Relationship
Type: Conceptual recall | Stem: Which phase of the nurse–
patient relationship is characterized by establishing rapport,
clarifying expectations, and setting boundaries?
Options:
A. Working phase
,B. Termination phase
C. Orientation (introductory) phase
D. Transference phase
Correct Answer: C
Rationale — Correct: The orientation phase is when rapport,
roles, expectations, and initial boundaries are set—foundational
for therapeutic relationships. Cite: Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 9: The Nurse–Patient Relationship.
Rationales — Incorrect:
A. Working phase focuses on interventions and problem solving.
B. Termination phase focuses on closure and summarizing gains.
D. Transference is a psychodynamic phenomenon, not a
relationship phase.
NCLEX/HESI applicability: Assesses professional role and
therapeutic relationship competencies in psychosocial integrity.
Teaching Point: Set clear roles, expectations, and boundaries
during orientation.
Mapping: Chapter 9 — The Nurse–Patient Relationship —
Phases of relationship; Key Concept: orientation phase tasks.
3 — Chapter & Subtopic: Chapter 11: Pharmacology, Dietary
Supplements, and Biologic Interventions — Antipsychotic
Monitoring
Type: Application | Stem: A client started on haloperidol
reports stiffness, drooling, and a stiff neck 5 days after initiation.
Which nursing action is most appropriate first?
, Options:
A. Reassure the client that these are expected and will resolve.
B. Hold the medication and notify the prescriber for possible
acute dystonia treatment (e.g., diphenhydramine or
benztropine).
C. Check the Abnormal Involuntary Movement Scale (AIMS) and
document mild changes.
D. Encourage fluids and ambulation; continue the current dose.
Correct Answer: B
Rationale — Correct: Sudden muscle rigidity and
oculogyric/neck dystonia suggest acute dystonic reaction—an
EPS emergency; immediate medication hold and
anticholinergic/antihistamine administration is indicated. Cite:
Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 11:
Pharmacology... (Antipsychotic monitoring); guideline: DSM-5-
TR (2022) description of antipsychotic side effects.
Rationales — Incorrect:
A. Dangerous — minimizes an urgent side effect.
C. AIMS targets tardive dyskinesia; acute dystonia needs
immediate treatment.
D. Continued dosing risks worsening dystonia and airway
compromise.
NCLEX/HESI applicability: Tests safe medication administration,
recognition of adverse effects, and timely reporting
(Physiological Integrity: Pharmacological Therapies).
Teaching Point: Treat acute dystonia immediately — hold med
and give anticholinergic/antihistamine.
