ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1. Question 1 — Chapter 1: Foundations of Psychiatric
Nursing — Therapeutic Relationship
Type: Conceptual recall
Stem: A nurse begins an initial interview with a new
inpatient who is guarded and quiet. Which nursing action
best establishes a therapeutic relationship?
Options:
A. Share a similar personal experience to build rapport.
B. Sit facing the patient, introduce self, state purpose, and
invite the patient to share at their own pace.
C. Immediately begin a thorough psychosocial history to
obtain information efficiently.
D. Use humor to reduce tension and encourage disclosure.
Correct Answer: B
Rationale — Correct: Introducing oneself, stating the
, purpose, sitting attentively, and inviting the patient to
share respects autonomy, communicates safety, and begins
rapport-building. This is a core therapeutic relationship
skill.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 1:
Foundations — Therapeutic Relationship.
Rationales — Incorrect:
• A: Self-disclosure may be therapeutic only when brief,
purposeful, and clinically justified; sharing personal stories
early risks shifting focus from patient.
• C: Rushing into data-gathering before rapport undermines
trust and may reduce accuracy of information.
• D: Humor can be misinterpreted and may minimize the
patient’s feelings; use cautiously and only after rapport is
established.
NCLEX/HESI applicability: Tests therapeutic
communication and establishment of a safe nurse–patient
relationship (Psychosocial Integrity; Therapeutic
Communication).
Teaching Point: Introduce, state purpose, and invite —
humility builds trust.
Mapping: Chapter 1 — Therapeutic Relationship —
Establishing rapport and boundaries.
,2. Question 2 — Chapter 1: Foundations — Therapeutic
Communication
Type: Application
Stem: A teen with anxiety says, “I feel like everyone is
judging me.” The nurse responds: “It sounds like you feel
judged and uncomfortable.” What therapeutic technique is
the nurse using?
Options:
A. Reflection
B. Interpretation
C. Reassurance
D. Advice giving
Correct Answer: A
Rationale — Correct: Reflection restates the patient’s
feelings, validating and clarifying emotion without
judgment — a key therapeutic communication skill.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 1:
Foundations — Therapeutic Communication.
Rationales — Incorrect:
• B: Interpretation attributes meaning beyond what patient
expressed and may be premature.
• C: Reassurance would minimize concerns (e.g., “Don’t
worry, it’s fine”), not reflect feelings.
• D: Advice prematurely directs behavior rather than
exploring feelings.
NCLEX/HESI applicability: Demonstrates therapeutic
, communication techniques used in psychiatric nursing
(Psychosocial Integrity).
Teaching Point: Reflection validates and clarifies patients'
feelings.
3. Question 3 — Chapter 2: Milieu & Recovery-Oriented
Care — Milieu Therapy
Type: Clinical scenario
Stem: On a locked psychiatric unit, a patient complains
that the unit's unstructured free time increases anxiety
and leads to conflict. Which nursing intervention best
supports therapeutic milieu principles?
Options:
A. Extend visiting hours so patients have outside contact.
B. Institute structured group activities during that time and
involve patients in planning.
C. Leave the time unstructured to promote autonomy.
D. Restrict movement to patient rooms during free time to
prevent conflict.
Correct Answer: B
Rationale — Correct: Milieu therapy emphasizes
structured, purposeful activities and patient involvement
in planning to promote safety, socialization, and recovery.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 2:
Milieu Therapy — Therapeutic Environment.
Rationales — Incorrect:
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1. Question 1 — Chapter 1: Foundations of Psychiatric
Nursing — Therapeutic Relationship
Type: Conceptual recall
Stem: A nurse begins an initial interview with a new
inpatient who is guarded and quiet. Which nursing action
best establishes a therapeutic relationship?
Options:
A. Share a similar personal experience to build rapport.
B. Sit facing the patient, introduce self, state purpose, and
invite the patient to share at their own pace.
C. Immediately begin a thorough psychosocial history to
obtain information efficiently.
D. Use humor to reduce tension and encourage disclosure.
Correct Answer: B
Rationale — Correct: Introducing oneself, stating the
, purpose, sitting attentively, and inviting the patient to
share respects autonomy, communicates safety, and begins
rapport-building. This is a core therapeutic relationship
skill.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 1:
Foundations — Therapeutic Relationship.
Rationales — Incorrect:
• A: Self-disclosure may be therapeutic only when brief,
purposeful, and clinically justified; sharing personal stories
early risks shifting focus from patient.
• C: Rushing into data-gathering before rapport undermines
trust and may reduce accuracy of information.
• D: Humor can be misinterpreted and may minimize the
patient’s feelings; use cautiously and only after rapport is
established.
NCLEX/HESI applicability: Tests therapeutic
communication and establishment of a safe nurse–patient
relationship (Psychosocial Integrity; Therapeutic
Communication).
Teaching Point: Introduce, state purpose, and invite —
humility builds trust.
Mapping: Chapter 1 — Therapeutic Relationship —
Establishing rapport and boundaries.
,2. Question 2 — Chapter 1: Foundations — Therapeutic
Communication
Type: Application
Stem: A teen with anxiety says, “I feel like everyone is
judging me.” The nurse responds: “It sounds like you feel
judged and uncomfortable.” What therapeutic technique is
the nurse using?
Options:
A. Reflection
B. Interpretation
C. Reassurance
D. Advice giving
Correct Answer: A
Rationale — Correct: Reflection restates the patient’s
feelings, validating and clarifying emotion without
judgment — a key therapeutic communication skill.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 1:
Foundations — Therapeutic Communication.
Rationales — Incorrect:
• B: Interpretation attributes meaning beyond what patient
expressed and may be premature.
• C: Reassurance would minimize concerns (e.g., “Don’t
worry, it’s fine”), not reflect feelings.
• D: Advice prematurely directs behavior rather than
exploring feelings.
NCLEX/HESI applicability: Demonstrates therapeutic
, communication techniques used in psychiatric nursing
(Psychosocial Integrity).
Teaching Point: Reflection validates and clarifies patients'
feelings.
3. Question 3 — Chapter 2: Milieu & Recovery-Oriented
Care — Milieu Therapy
Type: Clinical scenario
Stem: On a locked psychiatric unit, a patient complains
that the unit's unstructured free time increases anxiety
and leads to conflict. Which nursing intervention best
supports therapeutic milieu principles?
Options:
A. Extend visiting hours so patients have outside contact.
B. Institute structured group activities during that time and
involve patients in planning.
C. Leave the time unstructured to promote autonomy.
D. Restrict movement to patient rooms during free time to
prevent conflict.
Correct Answer: B
Rationale — Correct: Milieu therapy emphasizes
structured, purposeful activities and patient involvement
in planning to promote safety, socialization, and recovery.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 2:
Milieu Therapy — Therapeutic Environment.
Rationales — Incorrect:
