NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. A client recently had an abdominoperineal resection and colostomy. While the nurse changes the dressing, the client states, 'You think that it looks repulsive.' The nurse identifies that the client is using which defense mechanism?
- A. Projection
- B. Sublimation
- C. Compensation
- D. Intellectualization
Correct answer: A
Rationale: The correct answer is Projection. Projection is the defense mechanism where unacceptable feelings and emotions are attributed to others. In this scenario, the client is projecting their own feelings of repulsion onto the nurse. Sublimation involves substituting socially acceptable feelings to replace threatening ones. Compensation refers to overachievement in a different area to cover up a weakness. Intellectualization is the use of mental reasoning to avoid facing emotional aspects of a situation.
2. Which component of cultural competence is being demonstrated when the nurse motivates the immigrant to accept differences in the way a pregnant woman is cared for in her current residence?
- A. Cultural desire
- B. Cultural awareness
- C. Cultural knowledge
- D. Cultural encounters
Correct answer: A
Rationale: The correct answer is 'Cultural desire.' Cultural desire involves the nurse's motivation and commitment toward caring for individuals from diverse backgrounds. In this scenario, motivating the immigrant to accept differences in prenatal care reflects the nurse's genuine interest in providing culturally competent care. Cultural awareness involves self-examination of one's beliefs and biases. Cultural knowledge refers to understanding various cultural practices and beliefs. Cultural encounters focus on interactions across cultures to enhance communication and mutual understanding. Therefore, in this context, the nurse's actions align more closely with the concept of cultural desire.
3. Which of the following outcomes is most appropriate during the crisis stage of caring for a victim of domestic violence?
- A. The client will verbalize community resources from which to seek shelter after discharge.
- B. The client will write a plan to keep herself and her children safe.
- C. The client will contact an attorney for help with pressing charges.
- D. The client will be safe and receive treatment for injuries.
Correct answer: D
Rationale: During the crisis stage of caring for a victim of domestic violence, the immediate priority is ensuring the client's safety and providing treatment for any injuries sustained. This focuses on addressing the urgent physical and emotional needs of the victim. While options like verbalizing community resources or creating safety plans are important for long-term support, they are not the primary concerns during the crisis phase. Contacting an attorney for legal assistance, though vital in the future, is not the immediate priority during the crisis stage when the client's safety and health are at the forefront.
4. Which reaction toward the physical symptom would the nurse observe in a client with conversion disorder?
- A. Anger
- B. Apathy
- C. Anxiety
- D. Agitation
Correct answer: B
Rationale: In conversion disorder, the nurse would observe apathy toward the physical symptom. The development of the symptom serves as an unconscious method of reducing anxiety. The symptom is accepted passively, known as 'la belle indiff�rence.' There is no anger observed as symptoms are passively accepted. Similarly, there is no direct anxiety related to the physical symptom, as the conflict is resolved through the symptom development. While many individuals might experience agitation and seek to identify the cause of physical symptoms, in conversion disorder, there is an unusual calmness or indifference towards the physical manifestation, indicating apathy rather than other emotional responses.
5. Which factor is most critical for a single mother of 2 children who recently lost her job and does not know what to do?
- A. Developmental history of children
- B. Available situational supports
- C. Underlying unconscious conflict
- D. Willingness to restructure lifestyle
Correct answer: B
Rationale: In a crisis intervention, the priority is to identify available situational supports, such as family, friends, community resources, and social services, that can help the single mother and her children during this difficult time. Understanding the developmental history of the children may be important to assess their needs, but it is not the most critical factor in this immediate crisis. Exploring underlying unconscious conflicts is more suited for long-term therapy rather than crisis intervention. While the willingness to restructure lifestyle may eventually be necessary, the immediate focus should be on finding support systems to address the current crisis.
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