a 19 year old client is paralyzed in a car accident which statement used by the client would indicate to the nurse that the client was using the mecha a 19 year old client is paralyzed in a car accident which statement used by the client would indicate to the nurse that the client was using the mecha
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NCLEX Psychosocial Questions

1. A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of 'suppression'?

Correct answer: “I don’t remember anything about what happened to me.”

Rationale: The correct answer is, '“I don’t remember anything about what happened to me.”' Suppression involves willfully putting an unacceptable thought or feeling out of one’s mind. In this case, the client is purposely choosing not to remember details of the traumatic event to avoid dealing with the associated emotions. Choice B, '“I’d rather not talk about it right now,”' suggests avoidance or deflection rather than active suppression. Choice C, '“It’s the other entire guy’s fault! He was going too fast,”' indicates blaming someone else for the situation, which is a form of defense mechanism known as externalization. Choice D, '“My mother is heartbroken about this,”' expresses empathy towards the mother's emotions and does not demonstrate suppression of personal feelings.

2. After a needle stick occurs while removing the cap from a sterile needle, which action should the nurse take?

Correct answer: Select another sterile needle.

Rationale: After a needle stick, the needle is considered contaminated and should be discarded. The nurse should select another sterile needle to use. Completing an incident report is not necessary in this situation because the needle was sterile when the nurse was stuck and not in contact with any other person's body fluids. Notifying the supervisor immediately is not required as the situation can be managed by selecting a new needle. Disinfecting the needle with an alcohol swab is not recommended as it does not meet the standards of safe practice and infection control.

3. When assessing the mental status of a young school-aged child, which action would be important for the nurse to take?

Correct answer: Compare the child’s function from one occasion to another.

Rationale: To accurately assess the mental status of a young school-aged child, it is crucial for the nurse to compare the child’s function over time. This approach allows for a more objective evaluation of the child's mental status. While listening to the parents’ description of the child’s behavior can provide valuable insights, it may be biased and subjective. Engaging parents in discussions about the child’s feelings is important for overall understanding but may not directly assess the child's mental status. Directly questioning the child about their mental status can be threatening and may lead to anxiety, making it a less optimal approach compared to observing and comparing the child's function over time.

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?

Correct answer: Intimacy vs. isolation

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. A 37-year-old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagia resulting in anemia. She also has depression and pelvic pain. She is crying and states, 'I don’t know what to do—my primary health care provider is recommending a hysterectomy, but I haven’t had children yet!' Which response would the nurse provide?

Correct answer: 'This must feel so difficult for you. Children are really important to you?'

Rationale: The correct response is to acknowledge the client's feelings and provide an open-ended question to encourage further expression. By expressing empathy and understanding, the nurse can create a supportive environment for the client. This approach allows the client to explore her emotions and concerns freely. Option A, suggesting adoption, may come across as dismissive of the client's current emotional state and may not address her immediate needs. Option D is insensitive and dismissive of the client's feelings and desires regarding having children. It is important to avoid making assumptions or judgments about the client's situation. Option C is a duplicate of Option B, and while it shows empathy, it lacks variety in communication, which may limit the depth of the conversation and the nurse's understanding of the client's needs.

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