NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. A client with generalized anxiety disorder presents with restlessness and fatigue. Which additional clinical manifestation would the nurse monitor for?
- A. Hoarding
- B. Panic attacks
- C. Excessive worry
- D. Fear of leaving the house
Correct answer: C
Rationale: The nurse would monitor for excessive worry. Generalized anxiety disorder is characterized by physical and cognitive symptoms of chronic or excessive anxiety and worry. Excessive worry is a core feature of generalized anxiety disorder. Hoarding is a symptom of hoarding disorder, not generalized anxiety disorder. Panic attacks are typical of panic disorder, not generalized anxiety disorder. Fear of leaving the house is a characteristic of agoraphobia, which is distinct from generalized anxiety disorder.
2. What is the priority nursing action to assist an anxious father in his concern about not bonding with his newborn?
- A. Encouraging the father to participate in a parenting class
- B. Providing time for the father to be alone with and get to know the baby
- C. Offering the father a demonstration on newborn diapering, feeding, and bathing
- D. Allowing time for the father to ask questions after viewing a film about a new baby
Correct answer: B
Rationale: The priority nursing action to assist an anxious father in his concern about not bonding with his newborn is providing time for the father to be alone with and get to know the baby. Time alone provides the opportunity for paternal-infant attachment and bonding, which can help reduce the father's anxiety. Encouraging the father to participate in a parenting class, although helpful, does not directly address the immediate need for bonding. Offering a demonstration on newborn care tasks like diapering, feeding, and bathing may not effectively address the father's anxiety at that moment, as he may not be ready to absorb such information. Allowing time for the father to ask questions after viewing a film about a new baby is a simplistic approach that may not adequately address the emotional needs and concerns of the father regarding bonding with his newborn.
3. A client with invasive carcinoma of the bladder is scheduled for a cystectomy and an ileal conduit. The client expresses worries about the possibility of offensive odors associated with the urinary diversion. How would the nurse respond?
- A. ''Tell me more about your concerns.''
- B. ''Products are available to address this issue.''
- C. ''This is a valid concern, and we can discuss ways to manage it.''
- D. ''Many individuals who undergo this procedure have similar worries.''
Correct answer: A
Rationale: The response ''Tell me more about your concerns'' is open-ended, encouraging the client to express their worries freely. This approach fosters communication and shows empathy. Option B acknowledges the concern and offers a solution, demonstrating support and understanding. Option C validates the client's worry and suggests collaboration in finding solutions. Option D normalizes the concern but may not address the client's specific worries, making it less therapeutic than the other options. Overall, actively listening to the client's concerns and offering support are essential in providing holistic care.
4. Which clinical findings indicate positive signs and symptoms of schizophrenia?
- A. Withdrawal, poverty of speech, inattentiveness
- B. Flat affect, decreased spontaneity, asocial behavior
- C. Hypomania, labile mood swings, episodes of euphoria
- D. Bizarre behavior, auditory hallucinations, loose associations
Correct answer: D
Rationale: The correct answer is bizarre behavior, auditory hallucinations, and loose associations. These are positive symptoms of schizophrenia, reflecting a distortion or excess of normal function. Withdrawal, poverty of speech, inattentiveness, flat affect, decreased spontaneity, and asocial behavior are negative symptoms linked to schizophrenia, indicating a diminution or absence of normal function. Hypomania, labile mood swings, and episodes of euphoria are more characteristic of bipolar disorder, rather than schizophrenia.
5. Which action often triggers an episode of violence or aggression in a patient with a psychiatric diagnosis involving violent behavior?
- A. Obtaining a history
- B. Asking for input into care
- C. Enforcing rules
- D. Taking a walk
Correct answer: C
Rationale: Enforcing rules is often a trigger for patients with psychiatric diagnoses involving violent behavior. Limit-setting or denying patient demands can be perceived as control and intimidation, leading to aggressive responses. Nursing staff must respond calmly and professionally to prevent escalation. Avoiding such patients or matching their emotions can worsen the situation. Therefore, enforcing rules can provoke violent episodes in these patients.
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