NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. After 5 years of unprotected intercourse, a childless couple comes to the fertility clinic. The husband tells the nurse that his parents have promised to make a down payment on a house for them if his wife gets pregnant this year. Which response would the nurse provide?
- A. ''This must be very difficult for you with this added pressure.''
- B. 'Having a child is a decision you should make without your parents' input.''
- C. 'You're lucky. It's nice that your parents are making such a generous offer.''
- D. ''Five years without a pregnancy is a long time. You were right to come to the fertility clinic.''
Correct answer: A
Rationale: The correct response acknowledges the emotional challenge the couple is facing due to the added pressure of the incentive from the husband's parents. By expressing empathy and understanding, the nurse encourages the couple to open up about their feelings and concerns. Choice B is not the best response as it dismisses the husband's situation and fails to address the emotional impact of the added pressure. Choice C focuses on the parents' offer rather than the couple's emotional state, which is not the primary concern in this situation. Choice D, mentioning the duration of infertility, may come across as insensitive and may hinder open communication by potentially making the couple feel judged or discouraged.
2. Which approach would the healthcare provider use when managing the care of a client diagnosed with generalized anxiety disorder (GAD)?
- A. Creating an anxiety-free environment for the client
- B. Assisting the client with the development of healthy, adaptive coping mechanisms
- C. Avoiding triggers that produce anxiety in the client
- D. Providing reinforcement that the client's anxiety issues can be eliminated
Correct answer: B
Rationale: The healthcare provider would assist the client with the development of healthy, adaptive coping mechanisms. GAD is characterized by the maladaptive use of worrying as a coping mechanism. The ultimate goal is for the healthcare provider to help the client replace the ineffective worrying with effective, healthy coping mechanisms. Creating an anxiety-free environment is not feasible or recommended; the goal is to help the client learn to deal with anxiety in a healthy manner. While identifying triggers is important, avoiding all triggers that produce anxiety is often impractical. Providing reinforcement that anxiety issues can be eliminated is not appropriate as anxiety is a normal human experience that needs to be managed effectively rather than eliminated completely.
3. A client who has multiple sclerosis is admitted to the hospital with increasingly frequent and severe exacerbations. One day, the client's partner confides to the nurse, 'Life is getting very hard and depressing, and I am upset with myself for thinking about a nursing home.' After listening to the partner's concerns, which response would the nurse make?
- A. 'Joining a support group of people who are coping with this situation may be helpful.'
- B. 'You may be able to decrease your feelings of guilt by seeking counseling.'
- C. 'It would be helpful if you became involved in volunteer work at this time.'
- D. 'I recognize it's hard to deal with, but try to remember that this, too, shall pass.'
Correct answer: A
Rationale: Joining a support group of individuals facing similar circumstances can provide valuable support and the opportunity to share experiences, making it the most appropriate response. The response suggesting counseling to decrease feelings of guilt is premature because the partner did not directly express guilt and it may not be the most immediate need. Suggesting involvement in volunteer work at this time fails to address the partner's current emotional distress and may come across as dismissive. Offering false reassurance by stating 'this, too, shall pass' does not validate the partner's feelings and minimizes the seriousness of their concerns.
4. Why is it important for the nurse to inform the family about the client's situation?
- A. To decrease the client's anxiety
- B. To help the family better adapt to necessary role changes
- C. To improve communication between family and nursing staff
- D. To ensure a more relaxed atmosphere for the client
Correct answer: B
Rationale: It is crucial for the nurse to inform the family about the client's situation to help them better adapt to necessary role changes. By providing early notification, the family can start preparing for potential adjustments. While reducing the client's anxiety and improving communication with the nursing staff are important, the primary purpose is to assist the family in undertaking the required role changes. Creating a relaxed atmosphere for the client, although beneficial, is not the main objective in this situation.
5. An older woman has lived alone since the death of her husband 10 years ago, and she has a long list of vague complaints. Which assessment is the priority for the home health nurse to perform?
- A. Assess for feelings of loneliness and isolation.
- B. Determine if the client has unresolved grief.
- C. Determine if there are safety issues.
- D. Ask about the availability of support systems.
Correct answer: C
Rationale: The priority assessment for the home health nurse in this scenario is to determine if there are safety issues. The client is an older woman living alone with a long list of vague complaints, indicating several risk factors. Ensuring her safety should be the primary concern. While assessing for feelings of loneliness, isolation, or grief is important, ensuring the client's safety takes precedence due to her vulnerable situation. Although assessing the availability of support systems is essential in a home health assessment, safety issues must be addressed first given the client's profile.
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