ESSENTIALS OF PSYCHIATRIC NURSING,
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1
Question 1 — Chapter 8: Therapeutic Communication,
Principles of Therapeutic Communication
Type: Conceptual recall
Stem: A newly admitted patient with major depression sits
silently and avoids eye contact. Which nursing statement most
exemplifies therapeutic use of silence?
Options:
A. “You need to tell me what’s wrong so I can help.”
B. Sits quietly and nods; after a pause says, “I’m here when you
are ready to talk.”*
C. “Why won’t you look at me? That doesn’t help your
recovery.”
D. “I think you should call your family right now.”
,Correct Answer: B
Rationale — Correct: Silence with attentive presence and a
brief, open invitation encourages the patient to communicate at
their own pace and conveys acceptance. This exemplifies
therapeutic listening and nonjudgmental support.
Rationales — Incorrect:
• A: Demanding disclosure pressures the patient and is not
therapeutic.
• C: Confrontational language is nontherapeutic and may
increase withdrawal.
• D: Advising action without assessing readiness or consent
is premature.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and psychosocial integrity—key NCLEX
areas for psychiatric nursing.
Teaching Point: Use silence and presence to encourage
patient expression.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 8:
Therapeutic Communication — Principles of therapeutic
communication.
2
Question 2 — Chapter 9: The Nurse–Patient Relationship,
Establishing Boundaries
Type: Application
,Stem: A patient offers the nurse a gift (a small hand-knit scarf)
at discharge and insists the nurse accept it. What is the most
appropriate nursing response?
Options:
A. “I can’t accept gifts from patients under any circumstance.”
B. “Thank you — I appreciate it; I accept to show how much
you’ve improved.”
C. “Thank you — I’m touched. Hospital policy lets me accept
small, non-monetary gifts; I’ll keep it in my locker.”
D. “If you really care, you should donate money to the unit.”
Correct Answer: C
Rationale — Correct: This response thanks the patient,
acknowledges the gift, and aligns acceptance with typical
facility policy for small, non-monetary tokens while maintaining
professional boundaries.
Rationales — Incorrect:
• A: An absolute refusal may invalidate the patient’s
gratitude unnecessarily if policy allows small gifts.
• B: Accepting without reference to policy or boundaries
could blur professional limits.
• D: Steering to donations is inappropriate and might shame
the patient.
NCLEX/HESI applicability: Tests professional boundaries,
ethics, and legal/facility policy—Safe, Effective Care
Environment.
Teaching Point: Acknowledge gratitude while following
, facility policy and maintaining boundaries.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 9:
The Nurse–Patient Relationship — Professional
boundaries.
3
Question 3 — Chapter 11: Pharmacology, Dietary
Supplements, and Biologic Interventions — Antipsychotic
Monitoring
Type: Clinical scenario
Stem: A 28-year-old started risperidone 2 weeks ago for first-
episode psychosis. He reports restlessness and says he “can’t sit
still.” Which nursing action is most appropriate initially?
Options:
A. Assess for akathisia and offer PRN propranolol or
benzodiazepine per orders.
B. Immediately discontinue risperidone because side effects
indicate failure.
C. Reassure the patient this is normal and will pass without
intervention.
D. Increase risperidone dose to overcome symptoms.
Correct Answer: A
Rationale — Correct: Restlessness suggests akathisia, an
extrapyramidal side effect; nurses should assess, document,
and administer prescribed anti-akathisia measures (e.g.,
propranolol) or consult prescriber. Early recognition improves
3RD EDITION
MARY ANN BOYD; REBECCA LUEBBERT
TEST BANK
1
Question 1 — Chapter 8: Therapeutic Communication,
Principles of Therapeutic Communication
Type: Conceptual recall
Stem: A newly admitted patient with major depression sits
silently and avoids eye contact. Which nursing statement most
exemplifies therapeutic use of silence?
Options:
A. “You need to tell me what’s wrong so I can help.”
B. Sits quietly and nods; after a pause says, “I’m here when you
are ready to talk.”*
C. “Why won’t you look at me? That doesn’t help your
recovery.”
D. “I think you should call your family right now.”
,Correct Answer: B
Rationale — Correct: Silence with attentive presence and a
brief, open invitation encourages the patient to communicate at
their own pace and conveys acceptance. This exemplifies
therapeutic listening and nonjudgmental support.
Rationales — Incorrect:
• A: Demanding disclosure pressures the patient and is not
therapeutic.
• C: Confrontational language is nontherapeutic and may
increase withdrawal.
• D: Advising action without assessing readiness or consent
is premature.
NCLEX/HESI applicability: Demonstrates therapeutic
communication and psychosocial integrity—key NCLEX
areas for psychiatric nursing.
Teaching Point: Use silence and presence to encourage
patient expression.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 8:
Therapeutic Communication — Principles of therapeutic
communication.
2
Question 2 — Chapter 9: The Nurse–Patient Relationship,
Establishing Boundaries
Type: Application
,Stem: A patient offers the nurse a gift (a small hand-knit scarf)
at discharge and insists the nurse accept it. What is the most
appropriate nursing response?
Options:
A. “I can’t accept gifts from patients under any circumstance.”
B. “Thank you — I appreciate it; I accept to show how much
you’ve improved.”
C. “Thank you — I’m touched. Hospital policy lets me accept
small, non-monetary gifts; I’ll keep it in my locker.”
D. “If you really care, you should donate money to the unit.”
Correct Answer: C
Rationale — Correct: This response thanks the patient,
acknowledges the gift, and aligns acceptance with typical
facility policy for small, non-monetary tokens while maintaining
professional boundaries.
Rationales — Incorrect:
• A: An absolute refusal may invalidate the patient’s
gratitude unnecessarily if policy allows small gifts.
• B: Accepting without reference to policy or boundaries
could blur professional limits.
• D: Steering to donations is inappropriate and might shame
the patient.
NCLEX/HESI applicability: Tests professional boundaries,
ethics, and legal/facility policy—Safe, Effective Care
Environment.
Teaching Point: Acknowledge gratitude while following
, facility policy and maintaining boundaries.
Cite: Essentials of Psychiatric Nursing, 3rd Ed. — Chapter 9:
The Nurse–Patient Relationship — Professional
boundaries.
3
Question 3 — Chapter 11: Pharmacology, Dietary
Supplements, and Biologic Interventions — Antipsychotic
Monitoring
Type: Clinical scenario
Stem: A 28-year-old started risperidone 2 weeks ago for first-
episode psychosis. He reports restlessness and says he “can’t sit
still.” Which nursing action is most appropriate initially?
Options:
A. Assess for akathisia and offer PRN propranolol or
benzodiazepine per orders.
B. Immediately discontinue risperidone because side effects
indicate failure.
C. Reassure the patient this is normal and will pass without
intervention.
D. Increase risperidone dose to overcome symptoms.
Correct Answer: A
Rationale — Correct: Restlessness suggests akathisia, an
extrapyramidal side effect; nurses should assess, document,
and administer prescribed anti-akathisia measures (e.g.,
propranolol) or consult prescriber. Early recognition improves
