NCLEX-RN
NCLEX Psychosocial Questions
1. The nurse is caring for a newly admitted patient. Which intervention is the best example of a culturally appropriate nursing intervention?
- A. Insist that family members provide most of the patient's personal care.
- B. Maintain a personal space of at least 2 feet when assessing the patient.
- C. Ask permission before touching a patient during the physical assessment.
- D. Consider the patient's ethnicity as an important factor in planning care.
Correct answer: C
Rationale: Culturally appropriate nursing care requires sensitivity to the beliefs and practices of diverse cultural groups. Asking permission before touching a patient during a physical assessment is a universally respectful practice, as many cultures consider it disrespectful to touch a person without consent. This approach demonstrates respect for the patient's autonomy and cultural preferences. Maintaining a personal space of at least 2 feet can be a good practice for infection control or personal comfort but may not be culturally significant for all patients. Insisting that family members provide most of the patient's personal care may not align with the patient's cultural norms or preferences. Considering a patient's ethnicity as the most important factor in care planning overlooks the individuality of the patient and may lead to stereotyping or assumptions that are not accurate or helpful in providing tailored care.
2. What psychodynamic process is suggested by a client calling the emergency department during a suicide attempt?
- A. A cry for help
- B. A need for attention
- C. Ambivalence about dying
- D. An inability to stick to a decision
Correct answer: C
Rationale: The correct answer is 'Ambivalence about dying.' When a client calls the emergency department during a suicide attempt, it suggests conflicting feelings about living and dying. This act can indicate an unconscious desire to be stopped from dying, showing ambivalence between the wish to die and the wish to live. It is not primarily a cry for attention or a need to punish others. The client's intention of suicide alongside seeking help demonstrates the struggle between life and death, making ambivalence the key psychodynamic process at play.
3. A 20-year-old young adult has been recently admitted to the hospital. According to Erikson, which of the following stages is the adult in?
- A. Trust vs. mistrust
- B. Initiative vs. guilt
- C. Autonomy vs. shame
- D. Intimacy vs. isolation
Correct answer: D
Rationale: The young adult, at 20 years old, is in the stage of Intimacy vs. Isolation according to Erikson's psychosocial theory. This stage typically occurs during young adulthood, between the ages of approximately 19 and 40. The primary conflict in this stage revolves around the development of intimate, loving relationships with others. This stage focuses on establishing close bonds and connections with others, seeking emotional closeness and commitment. Choices A, B, and C are incorrect. Trust vs. mistrust is the stage that occurs in infancy, Initiative vs. guilt is in early childhood, and Autonomy vs. shame is in toddlerhood. These stages each represent different developmental challenges and conflicts that individuals face at various points in their lives.
4. 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.
5. A female nurse is assessing a male patient of Arab descent who is admitted with complaints of severe headaches. It is most important for the nurse to intervene if she takes which action?
- A. The nurse explains the 0 to 10 intensity pain scale.
- B. The nurse asks the patient when the headaches started.
- C. The nurse sits down at the bedside and closes the privacy curtain.
- D. The nurse calls for a male nurse to bring a hospital gown to the room.
Correct answer: C
Rationale: In some Arab cultures, it is not considered appropriate for a male to be alone with a female who is not his spouse. Therefore, it is important for the nurse to respect the patient's cultural beliefs and privacy by ensuring that a female nurse is not alone with the male patient. Sitting down at the bedside and closing the privacy curtain could potentially lead to a situation where the nurse is alone with the patient, which goes against the patient's cultural norms. The other actions, such as explaining the pain scale, asking about the onset of headaches, and requesting a male nurse to bring a hospital gown, are all appropriate and do not conflict with the patient's cultural beliefs.
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