NCLEX-RN
NCLEX Psychosocial Questions
1. A college athlete sustained a complete transection of the spinal cord while practicing on a trampoline. The health care provider explained that return of function to the lower extremities is not likely. Two weeks later, the client verbalizes the need to practice for an upcoming tournament. Which conclusion would the nurse make about the client's statement?
- A. Exhibiting denial
- B. Verbalizing a fantasy
- C. No longer able to adapt
- D. Motivated to recover mobility
Correct answer: A
Rationale: The correct answer is 'Exhibiting denial.' Denial is a common defense mechanism when facing a serious health issue. The individual rejects the existence of the problem due to the overwhelming anxiety and emotional distress it causes. In this case, the athlete's desire to practice for an upcoming tournament despite being informed about the unlikely return of lower extremity function indicates denial of the severity of their condition. Choice B, 'Verbalizing a fantasy,' is incorrect as a fantasy involves creating imagined events to fulfill unconscious wishes, which is not evident here. Choice C, 'No longer able to adapt,' is incorrect because the client is actually demonstrating a maladaptive coping mechanism by denying the reality of their situation. Choice D, 'Motivated to recover mobility,' is incorrect as the client's goal of practicing for a tournament does not align with the realistic expectation of recovering mobility after a complete spinal cord transection.
2. A client decides to have hospice care rather than undergo an extensive surgical procedure. Which ethical principle does the client's behavior illustrate?
- A. Justice
- B. Veracity
- C. Autonomy
- D. Beneficence
Correct answer: C
Rationale: The correct answer is 'Autonomy.' Autonomy refers to an individual's right to make decisions about their own care. In this scenario, the client is choosing hospice care over surgery, demonstrating their autonomy in making healthcare choices. Justice involves fairness and equality in the distribution of resources and services, which is not the primary ethical principle illustrated in this case. Veracity pertains to truthfulness and honesty, which is not directly related to the client's decision-making process. Beneficence refers to the duty to do good and act in the best interest of the patient, which is not the central ethical principle demonstrated by the client's decision for hospice care.
3. The nurse plans care for a hospitalized patient who uses culturally based treatments. Which action by the nurse is best?
- A. Encourage the use of diagnostic procedures.
- B. Coordinate the use of folk treatments with ordered medical therapies.
- C. Ask the patient to discontinue the cultural treatments during hospitalization.
- D. Teach the patient that folk remedies will interfere with orders by the healthcare provider.
Correct answer: B
Rationale: The best action for the nurse is to coordinate the use of folk treatments with ordered medical therapies. Many culturally based therapies can complement Western treatments and medications. It is essential for the nurse to integrate both traditional folk treatments and Western therapies to provide holistic care. Some culturally based treatments can effectively complement Western medicine in treating diseases. Encouraging the patient to continue some culturally based treatments during hospitalization can enhance their overall well-being. Asking the patient to discontinue cultural treatments or teaching that folk remedies interfere with Western therapies may not align with the patient's beliefs and could hinder their care.
4. A Hispanic patient complains of abdominal cramping caused by empacho. Which action should the nurse take first?
- A. Ask the patient what treatments are likely to help
- B. Massage the patient's abdomen until the pain subsides.
- C. Administer prescribed medications to decrease the cramping
- D. Offer to contact a curandero(a) for a visit to the patient
Correct answer: A
Rationale: When a Hispanic patient presents with abdominal cramping related to empacho, it is crucial for the nurse to first understand the patient's cultural beliefs and preferences before initiating any interventions. In the case of a culture-bound syndrome like empacho, it is essential to acknowledge and respect the patient's cultural background. While options like administering medications, arranging a visit by a curandero(a), or providing massage may have potential benefits, assessing the patient's beliefs ensures that interventions are culturally sensitive and aligned with the patient's values. By engaging the patient in a discussion about potential treatments, the nurse can gather valuable information to tailor care effectively, promoting trust and collaboration in the healthcare process. This patient-centered approach enhances the quality of care and fosters a culturally competent nursing practice. Therefore, asking the patient about preferred treatments is the most appropriate initial action to address the patient's condition effectively.
5. While planning care for a 2-year-old hospitalized child, which situation would the nurse most likely expect to affect the behavior?
- A. Strange bed and surroundings.
- B. Separation from parents.
- C. Presence of other toddlers.
- D. Unfamiliar toys and games.
Correct answer: B
Rationale: The correct answer is 'Separation from parents.' Separation anxiety is most evident from 6 months to 30 months of age. It is the greatest stress imposed on a toddler by hospitalization. If separation is avoided, young children have a tremendous capacity to withstand other stress. Choices A, C, and D are incorrect because while strange bed and surroundings, presence of other toddlers, and unfamiliar toys and games may contribute to some level of stress or discomfort, the separation from parents is the primary factor affecting the behavior of a 2-year-old hospitalized child.
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