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 nurse begins the first therapeutic interview with a
newly admitted client who has major depressive disorder.
Which nurse statement best establishes a therapeutic
relationship?
Options:
A. “Tell me everything that happened to make you feel this
way.”
B. “I’m here to work with you; we’ll set goals together and keep
things confidential.”
C. “You should try to think more positively and get out of bed.”
D. “If you don’t follow my plan, I’ll inform your family.”
Correct Answer: B
Rationale — Correct: Statement B sets collaborative
,expectations, emphasizes patient-centered goals and
confidentiality—core elements of a therapeutic relationship. It
fosters trust and engagement.
Rationales — Incorrect:
A. Too directive and overwhelming; invites broad disclosure
without structure.
C. Judgmental and minimizes the client’s experience; not
therapeutic.
D. Threatening and breaches trust/confidentiality, undermining
alliance.
NCLEX/HESI applicability: Relates to Psychosocial Integrity —
therapeutic communication, establishing a therapeutic nurse–
client relationship.
Teaching Point: Build trust with collaboration, confidentiality,
and patient-centered goals.
Mapping: Chapter 1 — Therapeutic Relationship — Key
Concept: establishing trust and collaboration.
2. Question 2 — Chapter 1: Foundations, Therapeutic
Communication
Type: Application
Stem: During a group milieu session, a client who is socially
withdrawn sits silently. Which nurse action demonstrates
therapeutic communication that encourages participation?
Options:
A. “Why aren’t you joining the group?”
,B. “I noticed you’re quiet; would it help to share one thought or
just listen?”
C. “You must speak up — everyone needs to participate.”
D. “If you don’t talk, I’ll ask the doctor to change your
medications.”
Correct Answer: B
Rationale — Correct: Option B uses observation, empathy, and
offers choice — supportive approaches that respect autonomy
and gently invite participation.
Rationales — Incorrect:
A. Confrontational and may increase withdrawal.
C. Coercive and threatens autonomy; countertherapeutic.
D. Threatens punitive action and misattributes behavior to
medication noncompliance.
NCLEX/HESI applicability: Psychosocial Integrity — therapeutic
communication and milieu facilitation.
Teaching Point: Use observation and offer choices to encourage
participation.
Mapping: Chapter 1 — Therapeutic Communication — Key
Concept: noncoercive invitation and empathy.
3. Question 3 — Chapter 2: Milieu Therapy & Recovery Model,
Milieu Management
Type: Clinical scenario**
Stem: A client in an inpatient psychiatric unit frequently leaves
communal dining early and isolates, claiming the other clients
, “talk about me.” Which nursing intervention best supports
recovery-oriented milieu care?
Options:
A. Encourage the client to sit in the hallway alone until ready.
B. Assign staff to remain with the client during meals and
debrief after to reinforce coping.
C. Tell the client that others are harmless and to eat faster.
D. Restrict the client’s visits to the dining area for safety.
Correct Answer: B
Rationale — Correct: Staff presence during meals provides
support, reduces anxiety, models social interaction, and offers
debriefing—consistent with recovery-oriented, person-centered
milieu care.
Rationales — Incorrect:
A. Isolation reinforces withdrawal and excludes therapeutic
support.
C. Dismisses the client’s perception and is invalidating.
D. Restriction is punitive and not recovery-oriented unless
safety requires it.
NCLEX/HESI applicability: Safe and Effective Care Environment
— Safety and Psychosocial Integrity — milieu interventions.
Teaching Point: Use staff-supported exposure and debriefing to
build coping and social skills.
Mapping: Chapter 2 — Milieu Therapy — Key Concept:
supportive staff presence and debriefing.
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 nurse begins the first therapeutic interview with a
newly admitted client who has major depressive disorder.
Which nurse statement best establishes a therapeutic
relationship?
Options:
A. “Tell me everything that happened to make you feel this
way.”
B. “I’m here to work with you; we’ll set goals together and keep
things confidential.”
C. “You should try to think more positively and get out of bed.”
D. “If you don’t follow my plan, I’ll inform your family.”
Correct Answer: B
Rationale — Correct: Statement B sets collaborative
,expectations, emphasizes patient-centered goals and
confidentiality—core elements of a therapeutic relationship. It
fosters trust and engagement.
Rationales — Incorrect:
A. Too directive and overwhelming; invites broad disclosure
without structure.
C. Judgmental and minimizes the client’s experience; not
therapeutic.
D. Threatening and breaches trust/confidentiality, undermining
alliance.
NCLEX/HESI applicability: Relates to Psychosocial Integrity —
therapeutic communication, establishing a therapeutic nurse–
client relationship.
Teaching Point: Build trust with collaboration, confidentiality,
and patient-centered goals.
Mapping: Chapter 1 — Therapeutic Relationship — Key
Concept: establishing trust and collaboration.
2. Question 2 — Chapter 1: Foundations, Therapeutic
Communication
Type: Application
Stem: During a group milieu session, a client who is socially
withdrawn sits silently. Which nurse action demonstrates
therapeutic communication that encourages participation?
Options:
A. “Why aren’t you joining the group?”
,B. “I noticed you’re quiet; would it help to share one thought or
just listen?”
C. “You must speak up — everyone needs to participate.”
D. “If you don’t talk, I’ll ask the doctor to change your
medications.”
Correct Answer: B
Rationale — Correct: Option B uses observation, empathy, and
offers choice — supportive approaches that respect autonomy
and gently invite participation.
Rationales — Incorrect:
A. Confrontational and may increase withdrawal.
C. Coercive and threatens autonomy; countertherapeutic.
D. Threatens punitive action and misattributes behavior to
medication noncompliance.
NCLEX/HESI applicability: Psychosocial Integrity — therapeutic
communication and milieu facilitation.
Teaching Point: Use observation and offer choices to encourage
participation.
Mapping: Chapter 1 — Therapeutic Communication — Key
Concept: noncoercive invitation and empathy.
3. Question 3 — Chapter 2: Milieu Therapy & Recovery Model,
Milieu Management
Type: Clinical scenario**
Stem: A client in an inpatient psychiatric unit frequently leaves
communal dining early and isolates, claiming the other clients
, “talk about me.” Which nursing intervention best supports
recovery-oriented milieu care?
Options:
A. Encourage the client to sit in the hallway alone until ready.
B. Assign staff to remain with the client during meals and
debrief after to reinforce coping.
C. Tell the client that others are harmless and to eat faster.
D. Restrict the client’s visits to the dining area for safety.
Correct Answer: B
Rationale — Correct: Staff presence during meals provides
support, reduces anxiety, models social interaction, and offers
debriefing—consistent with recovery-oriented, person-centered
milieu care.
Rationales — Incorrect:
A. Isolation reinforces withdrawal and excludes therapeutic
support.
C. Dismisses the client’s perception and is invalidating.
D. Restriction is punitive and not recovery-oriented unless
safety requires it.
NCLEX/HESI applicability: Safe and Effective Care Environment
— Safety and Psychosocial Integrity — milieu interventions.
Teaching Point: Use staff-supported exposure and debriefing to
build coping and social skills.
Mapping: Chapter 2 — Milieu Therapy — Key Concept:
supportive staff presence and debriefing.
