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 newly admitted client with major depressive
disorder is withdrawn and avoids eye contact. Which
therapeutic behavior by the nurse best fosters the
therapeutic relationship in the first 24 hours?
Options:
A. Offer advice about activities to “cheer up” the client.
B. Sit quietly at the client’s level and use simple, empathic
comments.
C. Share a personal story of recovery to build rapport.
D. Encourage the client to socialize with other patients
immediately.
Correct answer: B
Rationale — Correct: Sitting at the client’s level and using
, empathic, simple comments communicates respect, safety,
and acceptance and helps establish trust early in the
relationship. (2 sentences)
Rationales — Incorrect:
A. Advice-giving is premature and may inhibit trust-
building.
C. Self-disclosure should be limited and purposeful; early
personal stories risk shifting focus.
D. Pressuring socialization can overwhelm a withdrawn
client and harm rapport.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and professional conduct — core to
Psychosocial Integrity and Safe/Effective Care.
Teaching Point: Use empathic presence first; build trust
before teaching or advising.
Mapping: Chapter 1 — Therapeutic Relationship —
Establishing trust and empathy.
2. Question 2 — Chapter 2: Therapeutic Communication,
Verbal & Nonverbal Skills
Type: Application
Stem: During a panic attack, a client says, “I can’t breathe
— I’m going to die.” The nurse’s most therapeutic initial
response is:
Options:
A. “There’s nothing wrong — just breathe slowly.”
, B. “You’re safe here; I’ll stay with you and help you breathe
slowly.”
C. “Calm down; panic attacks pass quickly.”
D. “Do you think you could be allergic to something?”
Correct answer: B
Rationale — Correct: Providing reassurance of safety and
staying with the client while guiding breathing addresses
immediate physiological and emotional needs and reduces
isolation.
Rationales — Incorrect:
A. Minimizes feelings and may increase the client’s
distress.
C. Telling someone to calm down is dismissive and
nontherapeutic.
D. Speculation about allergy is irrelevant and distracts from
immediate management.
NCLEX/HESI applicability: Prioritizes safety and acute
symptom management (Psychosocial Integrity; Safety).
Teaching Point: Stay present, reassure safety, and use
guided breathing during panic.
3. Question 3 — Chapter 3: Milieu Therapy, Therapeutic
Environment
Type: Clinical scenario
Stem: On an acute psychiatric unit, several clients are
exhibiting agitation after mealtime. The nurse decides to
, use milieu strategies to reduce agitation. Which is the best
initial milieu intervention?
Options:
A. Escort all clients to individual rooms for isolation.
B. Offer a structured group activity with clear rules and a
brief time limit.
C. Increase staff rounds without informing clients.
D. Remove all furniture from the common area to prevent
aggression.
Correct answer: B
Rationale — Correct: Structured, time-limited activities
provide predictability and redirect energy, reducing
agitation while maintaining socialization and safety.
Rationales — Incorrect:
A. Immediate isolation may escalate distress unless safety
requires it.
C. Increased rounds without structure can feel intrusive
and worsen agitation.
D. Removing furniture is punitive and can create a barren,
dehumanizing environment.
NCLEX/HESI applicability: Applies therapeutic milieu
interventions and unit safety management (Safe, Effective
Care Environment; Psychosocial Integrity).
Teaching Point: Structure and predictability calm agitated
patients.
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 newly admitted client with major depressive
disorder is withdrawn and avoids eye contact. Which
therapeutic behavior by the nurse best fosters the
therapeutic relationship in the first 24 hours?
Options:
A. Offer advice about activities to “cheer up” the client.
B. Sit quietly at the client’s level and use simple, empathic
comments.
C. Share a personal story of recovery to build rapport.
D. Encourage the client to socialize with other patients
immediately.
Correct answer: B
Rationale — Correct: Sitting at the client’s level and using
, empathic, simple comments communicates respect, safety,
and acceptance and helps establish trust early in the
relationship. (2 sentences)
Rationales — Incorrect:
A. Advice-giving is premature and may inhibit trust-
building.
C. Self-disclosure should be limited and purposeful; early
personal stories risk shifting focus.
D. Pressuring socialization can overwhelm a withdrawn
client and harm rapport.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and professional conduct — core to
Psychosocial Integrity and Safe/Effective Care.
Teaching Point: Use empathic presence first; build trust
before teaching or advising.
Mapping: Chapter 1 — Therapeutic Relationship —
Establishing trust and empathy.
2. Question 2 — Chapter 2: Therapeutic Communication,
Verbal & Nonverbal Skills
Type: Application
Stem: During a panic attack, a client says, “I can’t breathe
— I’m going to die.” The nurse’s most therapeutic initial
response is:
Options:
A. “There’s nothing wrong — just breathe slowly.”
, B. “You’re safe here; I’ll stay with you and help you breathe
slowly.”
C. “Calm down; panic attacks pass quickly.”
D. “Do you think you could be allergic to something?”
Correct answer: B
Rationale — Correct: Providing reassurance of safety and
staying with the client while guiding breathing addresses
immediate physiological and emotional needs and reduces
isolation.
Rationales — Incorrect:
A. Minimizes feelings and may increase the client’s
distress.
C. Telling someone to calm down is dismissive and
nontherapeutic.
D. Speculation about allergy is irrelevant and distracts from
immediate management.
NCLEX/HESI applicability: Prioritizes safety and acute
symptom management (Psychosocial Integrity; Safety).
Teaching Point: Stay present, reassure safety, and use
guided breathing during panic.
3. Question 3 — Chapter 3: Milieu Therapy, Therapeutic
Environment
Type: Clinical scenario
Stem: On an acute psychiatric unit, several clients are
exhibiting agitation after mealtime. The nurse decides to
, use milieu strategies to reduce agitation. Which is the best
initial milieu intervention?
Options:
A. Escort all clients to individual rooms for isolation.
B. Offer a structured group activity with clear rules and a
brief time limit.
C. Increase staff rounds without informing clients.
D. Remove all furniture from the common area to prevent
aggression.
Correct answer: B
Rationale — Correct: Structured, time-limited activities
provide predictability and redirect energy, reducing
agitation while maintaining socialization and safety.
Rationales — Incorrect:
A. Immediate isolation may escalate distress unless safety
requires it.
C. Increased rounds without structure can feel intrusive
and worsen agitation.
D. Removing furniture is punitive and can create a barren,
dehumanizing environment.
NCLEX/HESI applicability: Applies therapeutic milieu
interventions and unit safety management (Safe, Effective
Care Environment; Psychosocial Integrity).
Teaching Point: Structure and predictability calm agitated
patients.
