NCLEX-RN
NCLEX Psychosocial Questions
1. A 5-year-old child has been recently admitted to the hospital. According to Erik Erikson's psychosocial development stages, the child is in which stage?
- A. Trust vs. mistrust
- B. Initiative vs. guilt
- C. Autonomy vs. shame and doubt
- D. Intimacy vs. isolation
Correct answer: B
Rationale: The correct answer is 'Initiative vs. guilt.' According to Erik Erikson's psychosocial development stages, children aged 3-6 years old are in the stage of initiative versus guilt. During this stage, children begin to assert their power and control over the environment. They develop a sense of purpose and direction, but may also experience feelings of guilt if they believe their actions have caused harm or conflict. Choices A, C, and D are incorrect. 'Trust vs. mistrust' is the first stage for infants, 'Autonomy vs. shame and doubt' is the second stage for toddlers, and 'Intimacy vs. isolation' is a stage that occurs later in adulthood.
2. Which is the most appropriate nursing intervention when providing care for parents who have experienced a stillbirth?
- A. Giving a detailed explanation of possible causes of the stillbirth
- B. Providing the parents the opportunity to say goodbye to their newborn
- C. Explaining that an autopsy is not recommended in the setting of a stillbirth
- D. Arranging follow-up care and providing information to the parents before they leave the hospital
Correct answer: B
Rationale: The most appropriate nursing intervention when caring for parents who have experienced a stillbirth is to provide them with the opportunity to say goodbye to their newborn. This helps in the grieving process and allows the parents closure. Giving a detailed explanation of possible causes of the stillbirth may overwhelm the parents and is not the immediate priority. While an autopsy can be performed in the case of a stillbirth, the decision should be discussed with the parents and their wishes respected. Arranging follow-up care and providing information before the parents leave the hospital is crucial in ensuring they have the necessary support and resources to cope with the loss effectively.
3. After attending group therapy, the client says, 'It helps to know that I'm not the only one with this type of problem.' Which concept does this statement reflect?
- A. Altruism
- B. Catharsis
- C. Universality
- D. Transference
Correct answer: C
Rationale: The client's statement reflects the concept of universality. Universality in group therapy signifies the understanding that one is not alone in their struggles, providing a sense of commonality and support among group members facing similar challenges. Altruism in group therapy involves offering support, insight, and encouragement to others, fostering personal growth and self-awareness. Catharsis pertains to group members sharing and expressing both negative and positive emotions with each other. Transference occurs when a client inadvertently projects feelings and perceptions onto the therapist that originally belonged to someone significant in their past, impacting the therapeutic relationship.
4. When doing an admission assessment for a patient, the nurse notices that the patient pauses before answering questions about the health history. Which action by the nurse is most appropriate?
- A. Interview a family member instead.
- B. Wait for the patient to answer the questions.
- C. Remind the patient that you have other patients who need care.
- D. Give the patient an assessment form listing the questions and a pen.
Correct answer: B
Rationale: When a patient pauses before answering questions about their health history, it is important for the nurse to be patient and wait for the patient to answer the questions. Patients from different cultures may take time to consider a question carefully before responding. By waiting patiently, the nurse shows respect for the patient's pace and helps foster a trusting relationship. Asking a family member to answer instead may not provide accurate information from the patient themselves. Reminding the patient about other patients needing care could make the patient feel rushed or unimportant. Giving the patient an assessment form and pen does not address the underlying reason for the pause and may come across as dismissive of the patient's need for time to respond thoughtfully.
5. While receiving a preoperative enema, a client starts to cry and says, 'I'm sorry you have to do this messy thing for me.' Which is the nurse's best response?
- A. I don't mind it.'
- B. 'You seem upset.'
- C. 'This is part of my job.'
- D. 'Nurses get used to this.'
Correct answer: B
Rationale: The nurse's best response in this situation is to acknowledge the client's emotional state, as it shows empathy and encourages further expression of feelings. Choice A, 'I don't mind it,' dismisses the client's emotions and does not address the underlying issue. Choice C, 'This is part of my job,' focuses on the task rather than the client's emotional needs. Choice D, 'Nurses get used to this,' minimizes the client's feelings and lacks empathy. By selecting choice B, 'You seem upset,' the nurse acknowledges the client's distress and opens the door for further communication and support.
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