NCLEX-RN
Psychosocial Integrity NCLEX RN Questions
1. The health care provider has changed a client's prescription from the PO to the IV route of administration. The nurse should anticipate which change in the pharmacokinetic properties of the medication?
- A. The client will experience increased tolerance to the drug's effects and may need a higher dose.
- B. The onset of action of the drug will occur more rapidly, resulting in a more rapid effect.
- C. The medication will be more highly protein-bound, increasing the duration of action.
- D. The therapeutic index will be increased, placing the client at greater risk for toxicity.
Correct answer: B
Rationale: When changing the route of administration from PO to IV, the absorption process is bypassed, leading to a more rapid onset of action of the medication and consequently a quicker effect. Choices A, C, and D are incorrect. Increased drug tolerance and higher doses are not typical outcomes of changing the route of administration. Protein binding does not increase with a change to IV administration; rather, it is the bioavailability and onset of action that are affected. Moreover, an increased therapeutic index reduces the risk of drug toxicity, contrary to what is stated in choice D.
2. Which communication technique is a part of therapeutic communication?
- A. Asking for explanations
- B. Showing sympathy to the client
- C. Asking personal questions of the client
- D. Providing relevant information to the client
Correct answer: D
Rationale: The correct answer is providing relevant information to the client. In therapeutic communication, it is essential to provide clients with all pertinent information to help them understand their health status and what to expect. This empowers clients and promotes trust in the nurse-client relationship. Asking for explanations, showing sympathy, and asking personal questions are examples of nontherapeutic communication techniques. Asking personal questions can intrude on the client's privacy and may not be relevant to their care. Showing sympathy, while well-intentioned, may come across as pity rather than true empathy. Asking for explanations can sometimes put clients on the defensive rather than fostering a collaborative dialogue.
3. A client is being treated for anxiety and desires to be free from anxious feelings and despair. According to Maslow's hierarchy of needs, which level does this client need to meet?
- A. Physiological
- B. Safety
- C. Belonging
- D. Self-esteem
Correct answer: B
Rationale: According to Maslow's hierarchy of needs, safety needs come right after physiological needs. Safety needs include feelings of security and stability. When a client is treated for anxiety and seeks to be free from anxious feelings and despair, they are primarily aiming to meet their safety needs. By addressing anxiety and moving towards a sense of safety, the client can progress to addressing higher-level needs. Choices A, C, and D are incorrect in this scenario. Physiological needs (Choice A) refer to basic needs like food, water, and shelter. Belonging (Choice C) and self-esteem (Choice D) are higher-level needs in Maslow's hierarchy that come after safety needs. Therefore, the most appropriate level for the client in this case is safety.
4. 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.
5. Which therapeutic technique can the nurse use when an anxious client exhibits pressured and rambling speech?
- A. Touch
- B. Silence
- C. Focusing
- D. Summarizing
Correct answer: C
Rationale: Focusing is the appropriate therapeutic technique to use when an anxious client exhibits pressured and rambling speech. By focusing on one specific aspect, the intended meaning is easier to understand and helps the client stay on track. Touch is not recommended in this scenario as it can invade the client's personal space and potentially increase anxiety. Silence may allow the client to continue rambling without addressing the underlying concerns. Summarizing requires the identification and exploration of the client's concerns, which may be challenging when the speech is pressured and disorganized.
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