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 new inpatient who
is withdrawn and suspicious. Which nurse action best
establishes a therapeutic relationship?
Options:
A. Sit quietly at the bedside and wait for the patient to
speak first.
B. Share a personal story to create rapport.
C. Introduce self, explain role and ask what the patient
would like to be called.
D. Immediately encourage the patient to discuss painful
childhood memories.
Correct Answer: C
Rationale — Correct: Introducing oneself, clarifying role,
, and asking for preferred name sets a respectful,
collaborative foundation and promotes trust (therapeutic
relationship principles). Cite: Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 1: Foundations — Therapeutic
relationship.
Rationales — Incorrect:
A. Passive waiting may be perceived as disinterest and
does not actively build rapport.
B. Self-disclosure is sometimes therapeutic but sharing
personal stories early can shift focus away from the
patient.
D. Encouraging immediate disclosure of trauma is intrusive
and may retraumatize the patient.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and professional boundaries (Psychosocial
Integrity; Therapeutic Communication).
Teaching Point: Begin with respectful introductions and
collaborative role clarification.
Mapping: Chapter 1 — Therapeutic Relationship —
Establishing trust via role clarity.
2. Question 2 — Chapter 2: Therapeutic Communication,
Active Listening
Type: Application
Stem: A client says, “I can’t sleep; I feel worthless.” The
most therapeutic nurse response is:
, Options:
A. “You should try harder to relax before bed.”
B. “Tell me more about what makes you feel worthless.”
C. “I know exactly how you feel.”
D. “You’ll be fine; everyone has bad nights.”
Correct Answer: B
Rationale — Correct: Inviting elaboration uses open-
ended, empathetic communication to explore feelings and
supports assessment. Cite: Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 2: Therapeutic Communication
— Active listening.
Rationales — Incorrect:
A. Advising without exploration is dismissive and non-
therapeutic.
C. Overidentification is boundary crossing and assumes
equivalence.
D. Minimizing the client’s experience undermines trust and
assessment.
NCLEX/HESI applicability: Reinforces therapeutic
communication and mental health assessment skills
(Psychosocial Integrity).
Teaching Point: Use open-ended prompts to explore
emotional content.
3. Question 3 — Chapter 4: Milieu Therapy & Recovery
Model, Milieu Management
, Type: Clinical scenario**
Stem: On a locked psychiatric unit, a new patient becomes
verbally angry and knocks over a trash can. Which staff
action best reflects effective milieu management?
Options:
A. Immediately place the patient in seclusion without
explanation.
B. Tell the patient to calm down and threaten transfer if
behavior continues.
C. Approach calmly, set a limit about safety, and offer a
quiet area to de-escalate.
D. Ignore the behavior to avoid reinforcing attention-
seeking.
Correct Answer: C
Rationale — Correct: Calm approach, limit-setting, and
offering de-escalation respects safety and therapeutic
milieu principles. Cite: Essentials of Psychiatric Nursing, 3rd
Ed. — Chapter 4: Milieu Therapy — Safety and structure.
Rationales — Incorrect:
A. Seclusion is restrictive and requires justification, least-
restrictive measures should be tried first.
B. Threats escalate fear and harm therapeutic rapport.
D. Ignoring potentially dangerous behavior jeopardizes
safety.
NCLEX/HESI applicability: Addresses safety, least-
restrictive interventions, and therapeutic environment
(Safe, Effective Care Environment).
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 new inpatient who
is withdrawn and suspicious. Which nurse action best
establishes a therapeutic relationship?
Options:
A. Sit quietly at the bedside and wait for the patient to
speak first.
B. Share a personal story to create rapport.
C. Introduce self, explain role and ask what the patient
would like to be called.
D. Immediately encourage the patient to discuss painful
childhood memories.
Correct Answer: C
Rationale — Correct: Introducing oneself, clarifying role,
, and asking for preferred name sets a respectful,
collaborative foundation and promotes trust (therapeutic
relationship principles). Cite: Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 1: Foundations — Therapeutic
relationship.
Rationales — Incorrect:
A. Passive waiting may be perceived as disinterest and
does not actively build rapport.
B. Self-disclosure is sometimes therapeutic but sharing
personal stories early can shift focus away from the
patient.
D. Encouraging immediate disclosure of trauma is intrusive
and may retraumatize the patient.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and professional boundaries (Psychosocial
Integrity; Therapeutic Communication).
Teaching Point: Begin with respectful introductions and
collaborative role clarification.
Mapping: Chapter 1 — Therapeutic Relationship —
Establishing trust via role clarity.
2. Question 2 — Chapter 2: Therapeutic Communication,
Active Listening
Type: Application
Stem: A client says, “I can’t sleep; I feel worthless.” The
most therapeutic nurse response is:
, Options:
A. “You should try harder to relax before bed.”
B. “Tell me more about what makes you feel worthless.”
C. “I know exactly how you feel.”
D. “You’ll be fine; everyone has bad nights.”
Correct Answer: B
Rationale — Correct: Inviting elaboration uses open-
ended, empathetic communication to explore feelings and
supports assessment. Cite: Essentials of Psychiatric
Nursing, 3rd Ed. — Chapter 2: Therapeutic Communication
— Active listening.
Rationales — Incorrect:
A. Advising without exploration is dismissive and non-
therapeutic.
C. Overidentification is boundary crossing and assumes
equivalence.
D. Minimizing the client’s experience undermines trust and
assessment.
NCLEX/HESI applicability: Reinforces therapeutic
communication and mental health assessment skills
(Psychosocial Integrity).
Teaching Point: Use open-ended prompts to explore
emotional content.
3. Question 3 — Chapter 4: Milieu Therapy & Recovery
Model, Milieu Management
, Type: Clinical scenario**
Stem: On a locked psychiatric unit, a new patient becomes
verbally angry and knocks over a trash can. Which staff
action best reflects effective milieu management?
Options:
A. Immediately place the patient in seclusion without
explanation.
B. Tell the patient to calm down and threaten transfer if
behavior continues.
C. Approach calmly, set a limit about safety, and offer a
quiet area to de-escalate.
D. Ignore the behavior to avoid reinforcing attention-
seeking.
Correct Answer: C
Rationale — Correct: Calm approach, limit-setting, and
offering de-escalation respects safety and therapeutic
milieu principles. Cite: Essentials of Psychiatric Nursing, 3rd
Ed. — Chapter 4: Milieu Therapy — Safety and structure.
Rationales — Incorrect:
A. Seclusion is restrictive and requires justification, least-
restrictive measures should be tried first.
B. Threats escalate fear and harm therapeutic rapport.
D. Ignoring potentially dangerous behavior jeopardizes
safety.
NCLEX/HESI applicability: Addresses safety, least-
restrictive interventions, and therapeutic environment
(Safe, Effective Care Environment).
