NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. On her first visit to the neonatal intensive care unit to see her preterm newborn, the mother's only comment to the nurse is, 'My baby looks so fragile. Do you think my child will make it?' Which is the most appropriate response by the nurse?
- A. "Many infants born as small as yours have done just fine."
- B. "The staff is confident in your child's prognosis because preterm babies do look like this at first."
- C. "It's understandable that your baby looks fragile to you. What have you learned about the condition?"
- D. "Your baby is not as fragile as it appears. Do you find it so frightening that you can't touch your child?"
Correct answer: C
Rationale: The nurse's response should aim to convey acceptance and encourage the mother to express her concerns. By saying, "It's understandable that your baby looks fragile to you. What have you learned about the condition?", the nurse acknowledges the mother's feelings and prompts her to share her understanding, fostering further communication and addressing any misconceptions. Choices A and B dismiss the mother's concerns by making general statements and do not encourage dialogue. Choice D implies judgment and may deter the mother from opening up about her fears.
2. Which term describes what an adolescent client is experiencing when she says to the nurse who has been caring for her, 'You're just like my mother; I hate you'?
- A. Insight
- B. Universality
- C. Transference
- D. Identification
Correct answer: C
Rationale: Transference occurs when a client unconsciously assigns feelings and attitudes originally associated with another important person in the client's life. In this scenario, the adolescent client is projecting emotions connected to her mother onto the nurse. This client's statement does not demonstrate insight but rather reflects the mechanism of transference. Universality refers to the sense that one is not alone in any situation, which is not evident in the client's statement. Identification is a defense mechanism where an individual takes on characteristics of someone considered admirable, which is not the case in this situation.
3. What should be the initial action for a client admitted to an alcohol rehabilitation center who has a strong odor of alcohol on their breath on the fourth day after admission?
- A. Ask where the client obtained the alcohol.
- B. Locate the alcoholic substance.
- C. Convey empathy and support to the client.
- D. Document the client's drinking behavior.
Correct answer: B
Rationale: The initial action should be to locate the alcoholic substance. The nurse needs to find and remove the substance to prevent the client or others from consuming more alcohol. Asking where the client obtained the alcohol is not the priority; the focus is on ensuring the client's safety. Conveying empathy and support is essential but should not be the first action in this scenario. Documenting the client's drinking behavior can be done after ensuring immediate safety measures are in place.
4. Which feeling would be difficult for a client with major depression to express?
- A. Need for comforting
- B. Anger toward others
- C. Remorse for past behaviors
- D. Feelings of low self-esteem
Correct answer: B
Rationale: Clients with major depression often have difficulty expressing anger toward others as their anger is typically directed inwards. Expressing the need for comforting is common among clients with major depression. They can also articulate remorse for past behaviors to an excessive degree. Furthermore, feelings of low self-esteem can be openly expressed by clients with major depression. Therefore, the difficulty in expressing anger toward others is the most appropriate choice as clients with major depression tend to internalize their anger.
5. The client admitted for uncontrolled diabetes is worried about how to pay bills for the family while hospitalized. Which statement by the nurse is therapeutic?
- A. "You are worried about paying your bills?"
- B. "Don't worry; your bills will get paid eventually."
- C. "When was the last time you were admitted for hyperglycemia?"
- D. "You really shouldn't be drinking alcohol because of your diagnosis of diabetes."
Correct answer: A
Rationale: The therapeutic communication technique used in this scenario is reflection. By repeating the client's concern, the nurse acknowledges the client's feelings and encourages further exploration of the topic. Choice A is correct as it reflects the client's worry without offering false assurance, advice, or using professional jargon. Choice B dismisses the client's concerns with false reassurance. Choice C introduces professional jargon, which may hinder effective communication. Choice D provides advice, which can limit the client's expression of feelings and concerns.
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