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 patient with major depressive
disorder sits quietly and avoids eye contact. The nurse
wants to begin building a therapeutic relationship. Which
nurse behavior best promotes trust in the initial
interactions?
Options:
A. Immediately offer reassurance that "everything will be
fine."
B. Sit at the patient's eye level, introduce self, and explain
the purpose of the interaction.
C. Ask the patient detailed questions about family history
right away.
, D. Share a personal story of recovery to normalize feelings.
Correct Answer: B
Rationale — Correct: Introducing oneself, explaining the
interaction, and sitting at eye level establishes transparent
boundaries and helps build trust early. These actions
communicate respect and predictability. (Essentials of
Psychiatric Nursing, 3rd Ed. — Chapter 1, Building the
Therapeutic Relationship.)
Rationales — Incorrect:
A. Reassurance is premature and may minimize the
patient's experience; it can undermine trust.
C. Detailed family history is appropriate later; initially such
questions may feel intrusive.
D. Self-disclosure of personal recovery can blur boundaries
and should be used sparingly and purposefully.
NCLEX/HESI applicability: Links to Psychosocial Integrity —
therapeutic communication, establishing rapport, and
therapeutic relationships.
Teaching Point: Establish clear, respectful introductions
and role expectations.
Mapping: Chapter 1 — Therapeutic Relationship — Key
Concept: Trust-building through introductions — NCLEX:
Psychosocial Integrity (Therapeutic Communication).
2. Question 2 — Chapter 1: Foundations, Therapeutic
Communication
,Type: Application
Stem: A patient with generalized anxiety disorder says, "I
can’t stop worrying about my job; I feel like I’ll fail." The
nurse responds:
Options:
A. "You shouldn’t worry so much — everything will work
out."
B. "Tell me more about what makes you think you'll fail."
C. "At least you have a job; other people are unemployed."
D. "You sound nervous — take deep breaths like I do."
Correct Answer: B
Rationale — Correct: An open-ended, nonjudgmental
prompt encourages exploration of specific fears and fosters
therapeutic dialogue. It is an example of facilitation and
clarification. (Essentials, Chapter 1, Therapeutic
Communication Techniques.)
Rationales — Incorrect:
A. Minimizes feelings and blocks communication.
C. Invalidates the patient's concerns and introduces
comparison.
D. Imposes advice and a personal technique; lacks
exploration of content.
NCLEX/HESI applicability: Psychosocial Integrity —
therapeutic communication and anxiety management.
Teaching Point: Use open-ended prompts to explore
patient concerns.
Mapping: Chapter 1 — Therapeutic Communication — Key
, Concept: Open-ended facilitation — NCLEX: Psychosocial
Integrity (Therapeutic Communication).
3. Question 3 — Chapter 2: Psychiatric Assessment, Mental
Status Exam
Type: Clinical scenario
Stem: During a mental status exam, a patient presents with
slowed speech, poor eye contact, flat affect, and delayed
responses. Which component of the mental status exam is
primarily being described?
Options:
A. Thought process
B. Mood and affect
C. Speech and psychomotor activity
D. Insight and judgment
Correct Answer: C
Rationale — Correct: Slowed speech and delayed
responses reflect speech and psychomotor activity; flat
affect relates to affect but the cluster best fits
speech/psychomotor domain. (Essentials, Chapter 2,
Mental Status Examination.)
Rationales — Incorrect:
A. Thought process pertains to organization of thinking
(e.g., tangentiality), not primarily speech rate.
B. Mood/affect includes flat affect, but does not account
for slowed speech and motor delay.
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 patient with major depressive
disorder sits quietly and avoids eye contact. The nurse
wants to begin building a therapeutic relationship. Which
nurse behavior best promotes trust in the initial
interactions?
Options:
A. Immediately offer reassurance that "everything will be
fine."
B. Sit at the patient's eye level, introduce self, and explain
the purpose of the interaction.
C. Ask the patient detailed questions about family history
right away.
, D. Share a personal story of recovery to normalize feelings.
Correct Answer: B
Rationale — Correct: Introducing oneself, explaining the
interaction, and sitting at eye level establishes transparent
boundaries and helps build trust early. These actions
communicate respect and predictability. (Essentials of
Psychiatric Nursing, 3rd Ed. — Chapter 1, Building the
Therapeutic Relationship.)
Rationales — Incorrect:
A. Reassurance is premature and may minimize the
patient's experience; it can undermine trust.
C. Detailed family history is appropriate later; initially such
questions may feel intrusive.
D. Self-disclosure of personal recovery can blur boundaries
and should be used sparingly and purposefully.
NCLEX/HESI applicability: Links to Psychosocial Integrity —
therapeutic communication, establishing rapport, and
therapeutic relationships.
Teaching Point: Establish clear, respectful introductions
and role expectations.
Mapping: Chapter 1 — Therapeutic Relationship — Key
Concept: Trust-building through introductions — NCLEX:
Psychosocial Integrity (Therapeutic Communication).
2. Question 2 — Chapter 1: Foundations, Therapeutic
Communication
,Type: Application
Stem: A patient with generalized anxiety disorder says, "I
can’t stop worrying about my job; I feel like I’ll fail." The
nurse responds:
Options:
A. "You shouldn’t worry so much — everything will work
out."
B. "Tell me more about what makes you think you'll fail."
C. "At least you have a job; other people are unemployed."
D. "You sound nervous — take deep breaths like I do."
Correct Answer: B
Rationale — Correct: An open-ended, nonjudgmental
prompt encourages exploration of specific fears and fosters
therapeutic dialogue. It is an example of facilitation and
clarification. (Essentials, Chapter 1, Therapeutic
Communication Techniques.)
Rationales — Incorrect:
A. Minimizes feelings and blocks communication.
C. Invalidates the patient's concerns and introduces
comparison.
D. Imposes advice and a personal technique; lacks
exploration of content.
NCLEX/HESI applicability: Psychosocial Integrity —
therapeutic communication and anxiety management.
Teaching Point: Use open-ended prompts to explore
patient concerns.
Mapping: Chapter 1 — Therapeutic Communication — Key
, Concept: Open-ended facilitation — NCLEX: Psychosocial
Integrity (Therapeutic Communication).
3. Question 3 — Chapter 2: Psychiatric Assessment, Mental
Status Exam
Type: Clinical scenario
Stem: During a mental status exam, a patient presents with
slowed speech, poor eye contact, flat affect, and delayed
responses. Which component of the mental status exam is
primarily being described?
Options:
A. Thought process
B. Mood and affect
C. Speech and psychomotor activity
D. Insight and judgment
Correct Answer: C
Rationale — Correct: Slowed speech and delayed
responses reflect speech and psychomotor activity; flat
affect relates to affect but the cluster best fits
speech/psychomotor domain. (Essentials, Chapter 2,
Mental Status Examination.)
Rationales — Incorrect:
A. Thought process pertains to organization of thinking
(e.g., tangentiality), not primarily speech rate.
B. Mood/affect includes flat affect, but does not account
for slowed speech and motor delay.
