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 is beginning care with a newly admitted
client who is anxious and reluctant to talk. Which initial
approach most effectively fosters a therapeutic
relationship?
Options:
A. Ask the client to describe their symptoms in full detail
immediately.
B. Offer a brief, calm introduction and explain the nurse’s
role and limits of confidentiality.
C. Share a personal story to make the client feel at ease.
D. Tell the client that discussing feelings is necessary for
discharge planning.
Correct Answer: B
, Rationale — Correct: A calm introduction with role
clarification and confidentiality establishes safety and
trust—foundations of therapeutic relationship building.
This orients the client and models professional boundaries.
Rationales — Incorrect:
• A: Gathering history is important but demanding full
details immediately can increase anxiety and hinder
rapport.
• C: Self-disclosure is sometimes therapeutic but sharing a
personal story at first contact risks blurring professional
boundaries.
• D: Framing disclosure as only necessary for discharge is
coercive and undermines trust.
NCLEX/HESI applicability: Links to Psychosocial Integrity
and Therapeutic Communication competencies;
emphasizes establishing rapport and safety.
Teaching Point: Begin with calm introductions and
role/confidentiality clarity.
Mapping: Chapter 1 — Therapeutic Relationship —
Building trust and professional boundaries.
2. Question 2 — Chapter 1: Foundations — Therapeutic
Communication
Type: Application
Stem: A client tearfully says, “I don’t know why I feel so
, hopeless.” Which nurse response uses therapeutic
communication to encourage exploration?
Options:
A. “You shouldn’t feel hopeless — things will get better.”
B. “Tell me more about what makes you feel hopeless.”
C. “I know exactly how you feel.”
D. “You need to take your medication and stop feeling
sorry for yourself.”
Correct Answer: B
Rationale — Correct: Open invitation (“Tell me more…”)
encourages elaboration and validates feelings—core
therapeutic communication.
Rationales — Incorrect:
• A: Minimizes the client’s feelings and may shut down
communication.
• C: Overidentification can reduce the client’s sense of being
heard and unique.
• D: Judgmental and directive; not therapeutic.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and psychosocial integrity.
Teaching Point: Use open-ended prompts to elicit feelings
and build rapport.
Mapping: Chapter 1 — Therapeutic Communication —
Open-ended invitations for emotional exploration.
, 3. Question 3 — Chapter 2: Milieu Therapy & Recovery
Model — Milieu Management
Type: Application
Stem: On an inpatient psychiatric unit, a patient repeatedly
isolates and refuses group activities, reporting fear of
others. Which nurse action best reflects milieu therapy
principles?
Options:
A. Allow the patient to isolate; avoid pressuring them.
B. Force the patient to attend the next group activity.
C. Offer a guided, small-step approach: invite to a brief
one-on-one activity, then a small group.
D. Discharge the patient for nonparticipation.
Correct Answer: C
Rationale — Correct: Milieu therapy uses structured,
supportive social interactions and graded exposure to
encourage community participation safely.
Rationales — Incorrect:
• A: Nonintervention misses therapeutic opportunities.
• B: Forcing attendance violates autonomy and may increase
distress.
• D: Discharging for nonparticipation ignores clinical need
and recovery orientation.
NCLEX/HESI applicability: Reflects Safe and Effective Care
Environment — therapeutic environment and patient-
centered care.
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 is beginning care with a newly admitted
client who is anxious and reluctant to talk. Which initial
approach most effectively fosters a therapeutic
relationship?
Options:
A. Ask the client to describe their symptoms in full detail
immediately.
B. Offer a brief, calm introduction and explain the nurse’s
role and limits of confidentiality.
C. Share a personal story to make the client feel at ease.
D. Tell the client that discussing feelings is necessary for
discharge planning.
Correct Answer: B
, Rationale — Correct: A calm introduction with role
clarification and confidentiality establishes safety and
trust—foundations of therapeutic relationship building.
This orients the client and models professional boundaries.
Rationales — Incorrect:
• A: Gathering history is important but demanding full
details immediately can increase anxiety and hinder
rapport.
• C: Self-disclosure is sometimes therapeutic but sharing a
personal story at first contact risks blurring professional
boundaries.
• D: Framing disclosure as only necessary for discharge is
coercive and undermines trust.
NCLEX/HESI applicability: Links to Psychosocial Integrity
and Therapeutic Communication competencies;
emphasizes establishing rapport and safety.
Teaching Point: Begin with calm introductions and
role/confidentiality clarity.
Mapping: Chapter 1 — Therapeutic Relationship —
Building trust and professional boundaries.
2. Question 2 — Chapter 1: Foundations — Therapeutic
Communication
Type: Application
Stem: A client tearfully says, “I don’t know why I feel so
, hopeless.” Which nurse response uses therapeutic
communication to encourage exploration?
Options:
A. “You shouldn’t feel hopeless — things will get better.”
B. “Tell me more about what makes you feel hopeless.”
C. “I know exactly how you feel.”
D. “You need to take your medication and stop feeling
sorry for yourself.”
Correct Answer: B
Rationale — Correct: Open invitation (“Tell me more…”)
encourages elaboration and validates feelings—core
therapeutic communication.
Rationales — Incorrect:
• A: Minimizes the client’s feelings and may shut down
communication.
• C: Overidentification can reduce the client’s sense of being
heard and unique.
• D: Judgmental and directive; not therapeutic.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and psychosocial integrity.
Teaching Point: Use open-ended prompts to elicit feelings
and build rapport.
Mapping: Chapter 1 — Therapeutic Communication —
Open-ended invitations for emotional exploration.
, 3. Question 3 — Chapter 2: Milieu Therapy & Recovery
Model — Milieu Management
Type: Application
Stem: On an inpatient psychiatric unit, a patient repeatedly
isolates and refuses group activities, reporting fear of
others. Which nurse action best reflects milieu therapy
principles?
Options:
A. Allow the patient to isolate; avoid pressuring them.
B. Force the patient to attend the next group activity.
C. Offer a guided, small-step approach: invite to a brief
one-on-one activity, then a small group.
D. Discharge the patient for nonparticipation.
Correct Answer: C
Rationale — Correct: Milieu therapy uses structured,
supportive social interactions and graded exposure to
encourage community participation safely.
Rationales — Incorrect:
• A: Nonintervention misses therapeutic opportunities.
• B: Forcing attendance violates autonomy and may increase
distress.
• D: Discharging for nonparticipation ignores clinical need
and recovery orientation.
NCLEX/HESI applicability: Reflects Safe and Effective Care
Environment — therapeutic environment and patient-
centered care.
