NCLEX-RN
NCLEX Psychosocial Questions
1. The nurse is caring for a Native American patient who has traditional beliefs about health and illness. Which action by the nurse is most appropriate?
- A. Avoid asking questions unless the patient initiates the conversation.
- B. Ask the patient whether it is important that cultural healers are contacted.
- C. Explain the usual hospital routines for meal times, care, and family visits.
- D. Obtain further information about the patient's cultural beliefs from a family member.
Correct answer: B
Rationale: When caring for a patient with traditional health beliefs, it is essential to respect and address their cultural practices. Asking the patient whether it is important to involve cultural healers, such as a shaman, aligns with providing culturally sensitive care. Avoiding asking questions unless initiated by the patient may hinder effective communication and understanding of the patient's needs. Consulting a family member for cultural beliefs assumes that all family members share the same beliefs, which may not be accurate. Additionally, the patient's personal beliefs should be prioritized over family input. Explaining hospital routines without considering the patient's cultural preferences may lead to a lack of patient-centered care. Therefore, the most appropriate action is to inquire about the patient's preference regarding cultural healers.
2. Which statement regarding an interpreter is correct?
- A. Relatives or friends of the client cannot serve as interpreters.
- B. The interpreter should aim to convey meaning rather than provide literal translations.
- C. Interpreting not only the language but also the culture is important.
- D. The interpreter should be available only during client-provider communication.
Correct answer: C
Rationale: The correct answer is that interpreting not only the language but also the culture is important. Health care facilities should provide professional interpreters to ensure accurate communication with clients who do not speak English proficiently. It is crucial for interpreters to understand and convey cultural nuances to prevent misunderstandings. Relatives or friends of the client should not serve as interpreters as they may not be impartial or adequately skilled. Providing literal word-for-word translations is not always effective as it may not capture the intended meaning. Interpreters should be available throughout the client's care process, not just during direct communication, to ensure effective and culturally sensitive care.
3. After a client has a spontaneous abortion at 12 weeks' gestation, the nurse notes that both she and her partner are visibly upset and crying. Which statement would be a therapeutic response?
- A. 'I'll be here if you want to talk.''
- B. 'Try to relax"?it'll speed up the healing process.''
- C. 'With any luck, you'll get pregnant again soon.''
- D. 'It's best that this happened early rather than having the baby die after it was born.''
Correct answer: A
Rationale: A therapeutic response in this situation is to offer support and empathy. Saying, 'I'll be here if you want to talk' gives the client and her partner the opportunity to express their emotions and seek comfort. It acknowledges their distress and assures them of the nurse's availability. Choice B, advising to relax to speed up the healing process, dismisses their current emotions and may hinder open communication. Choice C, suggesting getting pregnant again soon, minimizes their grief over the loss and may not be what the couple needs to hear at that moment. Choice D, stating it's best that the miscarriage happened early, is insensitive as it invalidates the couple's feelings of loss and grief. Grieving is a natural process, and the timing of the loss does not diminish its significance.
4. 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.
5. 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.
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