NCLEX-RN
NCLEX Psychosocial Questions
1. A client who exhibits blurred and double vision and muscular weakness is informed of the diagnosis of multiple sclerosis (MS). The client becomes visibly upset. Which response would the nurse make?
- A. That must have shocked you. Tell me what the health care provider told you about it.
- B. You should see a psychiatrist who will help you cope with this overwhelming news.
- C. Don't worry; early treatment often alleviates the symptoms of the disease.
- D. You should be glad that we caught it early so you can be cured.
Correct answer: A
Rationale: The response 'That must have shocked you. Tell me what the health care provider told you about it' acknowledges the effect of the diagnosis on the client and explores what is known. This response shows empathy and encourages the client to share their understanding. There is no evidence of ineffective coping, so a referral to a psychiatrist is not necessary at this initial stage. The statement 'Don't worry; early treatment often alleviates symptoms of the disease' provides false reassurance as the course of MS varies for each individual and may not always respond well to treatment. The statement 'You should be glad we caught it early so it can be cured' does not address the client's current emotional state and is inaccurate; MS is a chronic autoimmune disease that currently has no cure.
2. Which action by a client who requires an above-the-knee amputation for peripheral arterial disease best indicates emotional readiness for the surgery?
- A. Explains the goals of the procedure
- B. Displays few signs of anticipatory grief
- C. Participates in learning perioperative care
- D. Verbalizes acceptance of permanent dependency needs
Correct answer: C
Rationale: Participating actively in learning self-care demonstrates emotional acceptance of the need for surgery and readiness for planning post-surgery. Explaining the goals of the procedure may reflect intellectual readiness but not necessarily emotional readiness. A client who shows few signs of anticipatory grief may be suppressing emotions or in denial, which can hinder the emotional readiness. Verbalizing acceptance of permanent dependency needs suggests the client may require further education and emotional support, as it may not reflect a healthy emotional readiness for the surgery.
3. A client who is at 28 weeks' gestation and in active labor is crying. She says, 'I just know that this baby is going to die. What's the use of doing all this to save it?' Which explanation would interpret the client's statements?
- A. She is depressed and needs gentle, positive support during labor.
- B. She is experiencing anticipatory grief and withdrawing from bonding.
- C. She is in need of emotional support to help her cope with the impending birth.
- D. She is struggling to cope with the birth by using the word 'it.'
Correct answer: B
Rationale: The client's statement indicates anticipatory grief, where she is preparing for a potential loss. This grief is not necessarily about the literal death of the baby but about the loss of the anticipated healthy full-term baby. The client may not be ready to bond with the reality of a preterm baby. Providing gentle, positive support is essential to help her cope with her feelings, as firm support may come across as dismissive. Sedation is not appropriate as it could hinder the client's emotional processing. Allowing the client to express her emotions and work through anticipatory grieving is crucial. The use of the word 'it' reflects the client's emotional struggle and is not the primary issue at hand.
4. The family of a child with cerebral palsy (CP) is at risk for difficult parenting issues. Which basis would the nurse conclude as the probable cause for this difficulty?
- A. Lack of social support
- B. Unrealistic expectations
- C. Loss of the expected healthy child
- D. Having a child with cognitive impairment
Correct answer: C
Rationale: The correct answer is 'Loss of the expected healthy child.' Parents of a child with cerebral palsy often grieve the loss of the healthy child they expected, mourning what could have been and what may never be. While lack of social support can contribute to parenting difficulties, it is not the primary basis in this case. Unrealistic expectations may play a role for some parents, but not all. Additionally, it is important to note that not all children with cerebral palsy experience cognitive impairment; around 30% to 50% of children with cerebral palsy have cognitive challenges.
5. The nurse develops a goal that makes a client feel as if they are engaging in a competition. Which type of motivation is the nurse using in this situation?
- A. Power motivation
- B. Affiliative motivation
- C. Avoidance motivation
- D. Achievement motivation
Correct answer: A
Rationale: The nurse is using power motivation in this situation. Power-motivated individuals tend to have assertive and aggressive behavior. By designing goals that make clients feel like they are in a competition, the nurse appeals to their need for power and accomplishment, even when they are competing against themselves. Affiliative motivation is characterized by nonassertive behavior and dependence on others, which is not applicable here. Avoidance motivation focuses on anxiety, fear of failure, and phobias, which are not relevant to the scenario. Achievement motivation does not involve aggressive behavior or the need for competition, making it an incorrect choice for this scenario.
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