NCLEX-RN
NCLEX Psychosocial Questions
1. What is a priority goal of involuntary hospitalization of the severely mentally ill client?
- A. Re-orientation to reality
- B. Elimination of symptoms
- C. Protection from harm to self or others
- D. Return to independent functioning
Correct answer: C
Rationale: The priority goal of involuntary hospitalization of severely mentally ill clients is to ensure protection from harm to self or others. Involuntary hospitalization is often necessary for individuals who are deemed dangerous to themselves or others or who are considered gravely disabled. Re-orientation to reality, elimination of symptoms, and return to independent functioning are important aspects of mental health care but are not the primary goals of involuntary hospitalization. The main focus during involuntary hospitalization is to address safety concerns and prevent harm.
2. 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.
3. 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.
4. Which approach would be most appropriate for the involved parent of a child diagnosed with Munchausen syndrome by proxy?
- A. Confrontation
- B. Open communication
- C. Health teaching about childrearing
- D. Validation of the child's physical status
Correct answer: B
Rationale: The most appropriate approach for the involved parent of a child diagnosed with Munchausen syndrome by proxy is open communication. Maintaining open communication is crucial in building a therapeutic nurse-client relationship. Confrontation may cause the parent to become defensive and hinder effective communication. Health teaching about childrearing may not be well-received at this point as the parent may not be ready for it. Validation of the child's physical status may inadvertently reinforce the parent's behavior by focusing solely on physical symptoms rather than addressing the underlying issues.
5. A client has just died, and their son states, 'She was the most wonderful mother. There was no one who was a better mother than she was. She was perfect.' Which stage of grief is this son experiencing?
- A. Denial
- B. Anger
- C. Idealization
- D. Shock
Correct answer: C
Rationale: The son is experiencing the idealization stage of grief. During this stage, individuals tend to idealize the deceased person and remember them in a highly positive light, overlooking any negative aspects. This idealization serves as a coping mechanism to deal with the loss. Choice A, Denial, is incorrect as denial involves refusing to accept the reality of the loss. Choice B, Anger, is incorrect as it involves feelings of resentment and frustration. Choice D, Shock, is incorrect as shock is the initial reaction to the loss and is different from idealizing the deceased individual.
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