NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which mental health disorder is most likely to be treated with electroconvulsive therapy (ECT)?
- A. Clinical depression
- B. Substance abuse disorder
- C. Antisocial personality disorder
- D. Psychosis occurring in schizophrenia
Correct answer: A
Rationale: Electroconvulsive therapy (ECT) is commonly used to treat severe cases of clinical depression in individuals who have not responded well to psychotropic medications or when immediate intervention is necessary due to the severity of the depression. ECT is not typically a first-line treatment for substance abuse disorders, antisocial personality disorder, or psychosis occurring in schizophrenia. Clients with clinical depression who meet specific criteria and have not benefited from other treatments may be considered for ECT to alleviate symptoms and improve overall functioning.
2. A client asks the nurse, 'Should I tell my partner that I just found out I'm human immunodeficiency virus (HIV) positive?' Which is the nurse's most appropriate response?
- A. Do not tell your partner unless asked.
- B. This is a decision you alone can make.
- C. You are having difficulty deciding what to say.
- D. Tell your partner that you don't know how you became sick.
Correct answer: C
Rationale: The most appropriate response for the nurse in this situation is to acknowledge the client's struggle in deciding what to communicate to their partner. By stating 'You are having difficulty deciding what to say,' the nurse validates the client's feelings and encourages further discussion. Option A is incorrect as it suggests withholding information unless asked, which may not align with ethical principles of honesty and transparency in relationships. Option B, while acknowledging the client's autonomy, does not provide direct support or guidance. Option D is inappropriate as it involves dishonesty by suggesting telling the partner an untruthful reason for the illness.
3. 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.
4. A client who is in a late stage of pancreatic cancer intellectually understands the terminal nature of the illness. Which behaviors indicate the client is emotionally accepting the impending death?
- A. Revising the client's will and planning a visit to a friend
- B. Alternating between crying and talking openly about death
- C. Seeking second, third, and fourth medical opinions
- D. Refusing to follow treatments and stating they won't help anyway
Correct answer: A
Rationale: Revising the will and planning a visit to a friend are indicative of emotional acceptance of impending death as they demonstrate realistic, productive, and constructive ways of using the remaining time. Alternating between crying and talking openly about death may suggest depression rather than acceptance. Seeking multiple medical opinions shows disbelief, denial, or desperation rather than acceptance. Refusing treatments and stating they won't help reflects anger and hopelessness, not acceptance.
5. A female adolescent has anorexia nervosa and is malnourished and severely underweight. Which statement indicates that she is experiencing secondary gains from her behavior?
- A. "I'm huge; I'm as big as a house."
- B. "I get straight A's in all my subjects."
- C. "My mother keeps trying to get me to eat."
- D. "My hair is beginning to fall out in clumps."
Correct answer: C
Rationale: The statement "My mother keeps trying to get me to eat" indicates that the adolescent is experiencing secondary gains from her behavior. This is because the behavior has garnered attention from her mother, providing a sense of power and control, which are considered secondary gains. The statement "I'm huge; I'm as big as a house" reflects a disturbed body perception and is not related to secondary gains. Getting straight A's in all subjects is an achievement but not a secondary gain related to anorexia nervosa. The hair falling out in clumps is a physical consequence of starvation, not a secondary gain.
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