ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter & Subtopic: Chapter 1 — Foundations of
Psychiatric Nursing: Therapeutic Relationship / Therapeutic
Communication
Type: Clinical scenario
Stem: A 28-year-old woman with new diagnosis of major
depressive disorder expresses shame and says, “I’m worthless.”
As the nurse, which initial therapeutic response most effectively
validates feelings and encourages further sharing?
Options:
A. “You shouldn’t say that — you have strengths.”
B. “Tell me more about what makes you feel worthless.”
C. “Everyone feels down sometimes — it will pass.”
D. “You must try to think positively and stop that thinking.”
Correct Answer: B
Rationale — Correct: Asking “Tell me more…” uses open-
ended, nonjudgmental therapeutic communication that
,validates and invites exploration of feelings. It supports rapport
and assessment of symptom severity. (Essentials Ch.1
Therapeutic Communication)
Rationales — Incorrect:
A. Gives premature reassurance and minimizes feelings.
C. Minimizes and normalizes without exploring patient’s unique
distress.
D. Imposes advice and is nontherapeutic; may increase shame.
NCLEX/HESI applicability: Tests therapeutic communication and
psychosocial integrity.
Teaching Point: Use open, nonjudgmental prompts to explore
emotions.
2 — Chapter & Subtopic: Chapter 1 — Foundations: Milieu
Therapy / Recovery Model
Type: Preventive/psychosocial guidance
Stem: On an inpatient unit adopting recovery-oriented milieu
therapy, which nursing action best supports patient
empowerment?
Options:
A. Nurse decides daily activities for all patients to ensure safety.
B. Nurse consults patients when creating daily schedules and
goal plans.
C. Nurse enforces strict visiting rules without exception.
D. Nurse limits patient choices to reduce conflict between
residents.
,Correct Answer: B
Rationale — Correct: Recovery-oriented milieu emphasizes
collaboration and shared decision-making; involving patients in
schedules promotes autonomy and therapeutic engagement.
(Essentials Ch.1 Milieu Therapy; Recovery Model)
Rationales — Incorrect:
A. Overly paternalistic; reduces autonomy.
C. Rigid enforcement without collaboration undermines
recovery.
D. Limiting choices decreases empowerment and therapeutic
progress.
NCLEX/HESI applicability: Relates to safe, patient-centered care
and therapeutic environment.
Teaching Point: Collaborate with patients to foster recovery and
empowerment.
3 — Chapter & Subtopic: Chapter 2 — Psychiatric Assessment:
Mental Status Exam — Risk Assessment for Suicidality
Type: Application
Stem: During assessment, a patient reports passive death
wishes but denies plan or intent. Which nursing action is most
appropriate next?
Options:
A. Document and discharge the patient home with outpatient
follow-up.
B. Conduct a more detailed suicidal risk assessment including
, intent, plan, means, and support.
C. Tell the patient “you’ll be fine” and leave for privacy.
D. Immediately place the patient in seclusion.
Correct Answer: B
Rationale — Correct: Passive ideation requires thorough risk
assessment (intent, plan, means, lethality, protective factors) to
inform safety planning; per MSE and risk protocols. (Essentials
Ch.2 Mental Status Exam; Suicide Risk)
Rationales — Incorrect:
A. Unsafe without complete risk assessment.
C. Minimizes risk and abandons assessment duty.
D. Seclusion is an extreme measure and inappropriate absent
imminent danger and due process.
NCLEX/HESI applicability: Safety and risk assessment; priority
nursing interventions.
Teaching Point: Always escalate to comprehensive risk
assessment when ideation present.
4 — Chapter & Subtopic: Chapter 3 — Psychopharmacology:
Antidepressant Monitoring
Type: Conceptual recall
Stem: A nurse teaching a patient starting an SSRI should
emphasize which common early adverse effect and appropriate
nursing advice?
Options:
A. Urinary retention — stop medication immediately.
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1 — Chapter & Subtopic: Chapter 1 — Foundations of
Psychiatric Nursing: Therapeutic Relationship / Therapeutic
Communication
Type: Clinical scenario
Stem: A 28-year-old woman with new diagnosis of major
depressive disorder expresses shame and says, “I’m worthless.”
As the nurse, which initial therapeutic response most effectively
validates feelings and encourages further sharing?
Options:
A. “You shouldn’t say that — you have strengths.”
B. “Tell me more about what makes you feel worthless.”
C. “Everyone feels down sometimes — it will pass.”
D. “You must try to think positively and stop that thinking.”
Correct Answer: B
Rationale — Correct: Asking “Tell me more…” uses open-
ended, nonjudgmental therapeutic communication that
,validates and invites exploration of feelings. It supports rapport
and assessment of symptom severity. (Essentials Ch.1
Therapeutic Communication)
Rationales — Incorrect:
A. Gives premature reassurance and minimizes feelings.
C. Minimizes and normalizes without exploring patient’s unique
distress.
D. Imposes advice and is nontherapeutic; may increase shame.
NCLEX/HESI applicability: Tests therapeutic communication and
psychosocial integrity.
Teaching Point: Use open, nonjudgmental prompts to explore
emotions.
2 — Chapter & Subtopic: Chapter 1 — Foundations: Milieu
Therapy / Recovery Model
Type: Preventive/psychosocial guidance
Stem: On an inpatient unit adopting recovery-oriented milieu
therapy, which nursing action best supports patient
empowerment?
Options:
A. Nurse decides daily activities for all patients to ensure safety.
B. Nurse consults patients when creating daily schedules and
goal plans.
C. Nurse enforces strict visiting rules without exception.
D. Nurse limits patient choices to reduce conflict between
residents.
,Correct Answer: B
Rationale — Correct: Recovery-oriented milieu emphasizes
collaboration and shared decision-making; involving patients in
schedules promotes autonomy and therapeutic engagement.
(Essentials Ch.1 Milieu Therapy; Recovery Model)
Rationales — Incorrect:
A. Overly paternalistic; reduces autonomy.
C. Rigid enforcement without collaboration undermines
recovery.
D. Limiting choices decreases empowerment and therapeutic
progress.
NCLEX/HESI applicability: Relates to safe, patient-centered care
and therapeutic environment.
Teaching Point: Collaborate with patients to foster recovery and
empowerment.
3 — Chapter & Subtopic: Chapter 2 — Psychiatric Assessment:
Mental Status Exam — Risk Assessment for Suicidality
Type: Application
Stem: During assessment, a patient reports passive death
wishes but denies plan or intent. Which nursing action is most
appropriate next?
Options:
A. Document and discharge the patient home with outpatient
follow-up.
B. Conduct a more detailed suicidal risk assessment including
, intent, plan, means, and support.
C. Tell the patient “you’ll be fine” and leave for privacy.
D. Immediately place the patient in seclusion.
Correct Answer: B
Rationale — Correct: Passive ideation requires thorough risk
assessment (intent, plan, means, lethality, protective factors) to
inform safety planning; per MSE and risk protocols. (Essentials
Ch.2 Mental Status Exam; Suicide Risk)
Rationales — Incorrect:
A. Unsafe without complete risk assessment.
C. Minimizes risk and abandons assessment duty.
D. Seclusion is an extreme measure and inappropriate absent
imminent danger and due process.
NCLEX/HESI applicability: Safety and risk assessment; priority
nursing interventions.
Teaching Point: Always escalate to comprehensive risk
assessment when ideation present.
4 — Chapter & Subtopic: Chapter 3 — Psychopharmacology:
Antidepressant Monitoring
Type: Conceptual recall
Stem: A nurse teaching a patient starting an SSRI should
emphasize which common early adverse effect and appropriate
nursing advice?
Options:
A. Urinary retention — stop medication immediately.
