a 37 year old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagi a 37 year old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagi
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NCLEX NCLEX-RN

Psychosocial Integrity NCLEX Questions

1. 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.

2. During a seminar on cultural aspects of nursing, the nurse recognizes that the definition stating, “the specific and distinct knowledge, beliefs, customs, and skills acquired by members of a society,” reflects which term?

Correct answer: Culture

Rationale: The term that best fits the provided definition, which includes knowledge, beliefs, customs, and skills acquired by members of a society, is 'Culture.' Culture is a broad concept encompassing various aspects of a society's way of life. Norms refer to typical behaviors or rules within a society. Ethnicity pertains to shared traits among a social group, such as origin, religion, language, and traditions. Assimilation involves adopting the dominant culture's characteristics, often through integration or conformity.

3. When asked to describe in layman's terms an overview of the condition called osteomyelitis, what would be the nurse's best response?

Correct answer: C: "Osteomyelitis is an infection in the bone. It can be caused by bacteria reaching your bone from outside or inside your body."

Rationale: Osteomyelitis is an infection in the bone that can be caused by bacteria reaching the bone either from outside the body (such as through an open fracture) or inside the body (such as through the bloodstream). This response provides a concise and accurate explanation of osteomyelitis, making it the best choice. Choices A and B provide inaccurate information about the condition, attributing it to age-related bone breakdown and Vitamin D deficiency, which are not correct causes of osteomyelitis. Choice D deflects the question instead of providing the patient with a clear explanation, making it an inappropriate response.

4. Which of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?

Correct answer: First-generation antipsychotic drugs

Rationale: The correct answer is first-generation antipsychotic drugs. These drugs are potent antagonists of D2, D3, and D4 receptors, making them effective in treating target symptoms but also leading to numerous extrapyramidal side effects due to the blockade of D2 receptors. Atypical or second-generation antipsychotic drugs, as mentioned in choice A, are relatively weak D2 blockers, which results in a lower incidence of extrapyramidal side effects. Third-generation antipsychotic drugs, as in choice C, and dopamine system stabilizers, as in choice D, are not typically associated with significant extrapyramidal effects compared to first-generation antipsychotics.

5. During the examination, it is often appropriate to offer some brief teaching about the patient’s body or the examiner’s findings. Which one of these statements by the nurse is most appropriate?

Correct answer: “Your pulse is 80 beats per minute, which is within the normal range.”

Rationale: During an examination, providing brief educational information to the patient can enhance rapport, as long as the patient can comprehend the terminology. The most appropriate statement from the nurse is "Your pulse is 80 beats per minute, which is within the normal range." This statement conveys a vital sign in a way that is likely understandable to the patient. Choices A, B, and D use terminology that may be unfamiliar or confusing to the patient. Option A mentions 'atrial dysrhythmias,' which might not be clear to the patient. Option B involves terms like 'pitting edema' and 'varicosities,' which could be unfamiliar to the patient. Option D references 'crackles,' 'wheezes,' and 'rubs,' which might not be easily understood by the patient.

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