ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter 1: Mental Health and Mental Disorders —
Fighting Stigma and Promoting Recovery
Type: Preventive/psychosocial guidance
Stem: A 28-year-old man with recently diagnosed major
depressive disorder says, “If people find out I have depression
they’ll think I’m weak.” Which nurse response best supports
recovery-oriented, anti-stigma practice?
Options:
A. “People who are weak usually get depressed; don’t worry.”
B. “It’s shameful—try to hide it from others.”
C. “Many people have treatable mental health conditions; let’s
talk about how stigma affects you.”
D. “You should just avoid talking about your diagnosis.”
Correct answer: C
Rationale — Correct: This response normalizes the condition,
opens therapeutic dialogue, and supports recovery-oriented
,coping and empowerment. (Essentials of Psychiatric Nursing,
3rd Ed. — Chapter 1: Mental Health and Mental Disorders:
Fighting Stigma and Promoting Recovery). Also aligns with
SAMHSA’s recovery principles (SAMHSA, 2014).
Rationales — Incorrect:
A. Blames the patient and reinforces stigma; nontherapeutic.
B. Encourages secrecy and avoidance, contrary to recovery
goals.
D. Discourages openness and therapeutic engagement.
NCLEX/HESI applicability: Tests therapeutic communication,
psychosocial integrity, and promoting patient dignity and
recovery.
Teaching Point: Normalize, validate, and explore stigma’s
impact to support recovery.
Mapping: Chapter 1 — Stigma & Recovery — Key Concept: Anti-
stigma communication and recovery principles.
2 — Chapter 8: Therapeutic Communication — Therapeutic
Communication
Type: Conceptual recall
Stem: Which therapeutic communication technique is most
appropriate when a patient says, “I can’t sleep because I feel
worthless”?
Options:
A. Giving advice (“You should get more sleep.”)
B. Minimizing (“That doesn’t sound so bad.”)
,C. Reflecting (“You feel worthless and that’s keeping you
awake.”)
D. Changing the subject (“Let’s talk about something else.”)
Correct answer: C
Rationale — Correct: Reflection shows empathy and helps the
patient explore feelings; it’s a core therapeutic communication
skill. (Essentials, Ch. 8: Therapeutic Communication).
Rationales — Incorrect:
A. Advice-giving can reduce patient autonomy and inhibit
expression.
B. Minimizing dismisses the patient’s experience.
D. Changing subject avoids emotional content and breaks
rapport.
NCLEX/HESI applicability: Evaluates therapeutic communication
and psychosocial integrity.
Teaching Point: Reflect feelings to deepen insight and rapport.
Mapping: Chapter 8 — Therapeutic techniques — Key Concept:
Reflection/empathy.
3 — Chapter 9: The Nurse–Patient Relationship — Nurse–
Patient Relationship / Boundaries
Type: Application
Stem: A nurse is assigned to care for a former client who
recently disclosed a close personal relationship with the nurse’s
family. What is the nurse’s best immediate action?
Options:
, A. Continue as assigned; keep the information private.
B. Accept assignment and intentionally share personal details to
bond.
C. Inform the supervisor and request reassignment due to dual-
relationship risk.
D. Refuse care and tell the client they must transfer.
Correct answer: C
Rationale — Correct: Dual relationships can impair objectivity
and safety; the nurse should disclose and request reassignment
per professional boundary standards. (Essentials, Ch. 9: The
Nurse–Patient Relationship).
Rationales — Incorrect:
A. Continuing without disclosure risks boundary violations.
B. Sharing personal details worsens dual-relationship risk.
D. Refusing care without following unit protocol is
inappropriate; disclosure and reassignment procedures are
correct.
NCLEX/HESI applicability: Tests legal/ethical practice,
professional boundaries, and safety.
Teaching Point: Disclose conflicts and request reassignment to
protect therapeutic boundaries.
Mapping: Chapter 9 — Boundaries & Dual Relationships — Key
Concept: Conflict disclosure and reassignment.
4 — Chapter 10: The Psychiatric–Mental Health Nursing
Process — Mental Status Exam / Diagnostic Reasoning
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter 1: Mental Health and Mental Disorders —
Fighting Stigma and Promoting Recovery
Type: Preventive/psychosocial guidance
Stem: A 28-year-old man with recently diagnosed major
depressive disorder says, “If people find out I have depression
they’ll think I’m weak.” Which nurse response best supports
recovery-oriented, anti-stigma practice?
Options:
A. “People who are weak usually get depressed; don’t worry.”
B. “It’s shameful—try to hide it from others.”
C. “Many people have treatable mental health conditions; let’s
talk about how stigma affects you.”
D. “You should just avoid talking about your diagnosis.”
Correct answer: C
Rationale — Correct: This response normalizes the condition,
opens therapeutic dialogue, and supports recovery-oriented
,coping and empowerment. (Essentials of Psychiatric Nursing,
3rd Ed. — Chapter 1: Mental Health and Mental Disorders:
Fighting Stigma and Promoting Recovery). Also aligns with
SAMHSA’s recovery principles (SAMHSA, 2014).
Rationales — Incorrect:
A. Blames the patient and reinforces stigma; nontherapeutic.
B. Encourages secrecy and avoidance, contrary to recovery
goals.
D. Discourages openness and therapeutic engagement.
NCLEX/HESI applicability: Tests therapeutic communication,
psychosocial integrity, and promoting patient dignity and
recovery.
Teaching Point: Normalize, validate, and explore stigma’s
impact to support recovery.
Mapping: Chapter 1 — Stigma & Recovery — Key Concept: Anti-
stigma communication and recovery principles.
2 — Chapter 8: Therapeutic Communication — Therapeutic
Communication
Type: Conceptual recall
Stem: Which therapeutic communication technique is most
appropriate when a patient says, “I can’t sleep because I feel
worthless”?
Options:
A. Giving advice (“You should get more sleep.”)
B. Minimizing (“That doesn’t sound so bad.”)
,C. Reflecting (“You feel worthless and that’s keeping you
awake.”)
D. Changing the subject (“Let’s talk about something else.”)
Correct answer: C
Rationale — Correct: Reflection shows empathy and helps the
patient explore feelings; it’s a core therapeutic communication
skill. (Essentials, Ch. 8: Therapeutic Communication).
Rationales — Incorrect:
A. Advice-giving can reduce patient autonomy and inhibit
expression.
B. Minimizing dismisses the patient’s experience.
D. Changing subject avoids emotional content and breaks
rapport.
NCLEX/HESI applicability: Evaluates therapeutic communication
and psychosocial integrity.
Teaching Point: Reflect feelings to deepen insight and rapport.
Mapping: Chapter 8 — Therapeutic techniques — Key Concept:
Reflection/empathy.
3 — Chapter 9: The Nurse–Patient Relationship — Nurse–
Patient Relationship / Boundaries
Type: Application
Stem: A nurse is assigned to care for a former client who
recently disclosed a close personal relationship with the nurse’s
family. What is the nurse’s best immediate action?
Options:
, A. Continue as assigned; keep the information private.
B. Accept assignment and intentionally share personal details to
bond.
C. Inform the supervisor and request reassignment due to dual-
relationship risk.
D. Refuse care and tell the client they must transfer.
Correct answer: C
Rationale — Correct: Dual relationships can impair objectivity
and safety; the nurse should disclose and request reassignment
per professional boundary standards. (Essentials, Ch. 9: The
Nurse–Patient Relationship).
Rationales — Incorrect:
A. Continuing without disclosure risks boundary violations.
B. Sharing personal details worsens dual-relationship risk.
D. Refusing care without following unit protocol is
inappropriate; disclosure and reassignment procedures are
correct.
NCLEX/HESI applicability: Tests legal/ethical practice,
professional boundaries, and safety.
Teaching Point: Disclose conflicts and request reassignment to
protect therapeutic boundaries.
Mapping: Chapter 9 — Boundaries & Dual Relationships — Key
Concept: Conflict disclosure and reassignment.
4 — Chapter 10: The Psychiatric–Mental Health Nursing
Process — Mental Status Exam / Diagnostic Reasoning
