NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. A client with generalized anxiety disorder presents with restlessness and fatigue. Which additional clinical manifestation would the nurse monitor for?
- A. Hoarding
- B. Panic attacks
- C. Excessive worry
- D. Fear of leaving the house
Correct answer: C
Rationale: The nurse would monitor for excessive worry. Generalized anxiety disorder is characterized by physical and cognitive symptoms of chronic or excessive anxiety and worry. Excessive worry is a core feature of generalized anxiety disorder. Hoarding is a symptom of hoarding disorder, not generalized anxiety disorder. Panic attacks are typical of panic disorder, not generalized anxiety disorder. Fear of leaving the house is a characteristic of agoraphobia, which is distinct from generalized anxiety disorder.
2. What initial treatment would the nurse expect for a preschool-aged child experiencing severe fear of the dark?
- A. Prescription medication
- B. Mental health counseling
- C. Cognitive behavioral therapy
- D. Repetition of brave statements
Correct answer: D
Rationale: Repetition of brave statements is an effective initial treatment for preschool-aged children with severe fear of the dark. This technique involves encouraging the child to repeat positive and reassuring statements to themselves to build confidence and reduce fear. Prescription medication is not typically the first-line approach for this type of fear in children due to potential side effects and safety concerns. Mental health counseling and cognitive behavioral therapy may be considered if the fear persists or is severe, but they are usually not the initial treatments for preschool-aged children with fear of the dark.
3. How is the secondary use of data from the 2000 census classification system utilized to address disparities in mental health care along racial-ethnic lines?
- A. To provide culturally relevant care to the required ethnic group
- B. To identify all racial and ethnic groups in the United States
- C. To identify why there are disparities in the United States
- D. To determine when and how the health care needs of the ethnic populations are being met
Correct answer: D
Rationale: The census classification system categorizes individuals based on racial and ethnic descriptions. Utilizing this data helps in identifying health disparities and assessing how the health care needs of ethnic populations are being addressed. Option A is incorrect because the primary focus is on analyzing healthcare needs met, not providing care. Option B is incorrect as the census does not encompass every single racial and ethnic group in the United States. Option C is incorrect as the census is not designed to investigate the reasons behind disparities, but rather to quantify and analyze them.
4. During a clinic visit, the mother of a 7-year-old reports to the nurse that her child is often awake until midnight playing and is then very difficult to awaken in the morning for school. Which assessment data should the nurse obtain in response to the mother's report?
- A. The occurrence of any episodes of sleep apnea
- B. The child's blood pressure, pulse, and respirations
- C. Length of rapid eye movement (REM) sleep that the child is experiencing
- D. Description of the family's home environment
Correct answer: D
Rationale: When a school-age child has difficulty going to sleep and waking up in the morning, it is important to assess the family's home environment. This includes factors such as bedtime rituals, noise levels, lighting, use of electronic devices, and overall sleep hygiene practices. Understanding the home environment can help identify issues that may be contributing to the child's sleep problems and guide the development of a plan to promote better sleep habits. Options A, B, and C are less relevant in this scenario. Sleep apnea typically causes daytime fatigue rather than resistance to bedtime. Assessing vital signs like blood pressure, pulse, and respirations is unlikely to provide insights into the child's sleep patterns. Monitoring REM sleep duration is not practical in a clinical setting and may not directly address the reported sleep issues in this case.
5. After receiving written and verbal instructions from a clinic nurse about a newly prescribed medication, a client asks the nurse what to do if questions arise about the medication after getting home. How should the nurse respond?
- A. Provide the client with a list of reliable internet sites that offer information on medications.
- B. Advise the client to obtain a current edition of a drug reference book from a local bookstore or library.
- C. Reassure the client that information about the medication is included in the written instructions.
- D. Encourage the client to call the clinic nurse or healthcare provider if any questions arise.
Correct answer: D
Rationale: To ensure safe medication use, the nurse should encourage the client to call the clinic nurse or healthcare provider if any questions arise. This direct communication allows for personalized assistance and clarification tailored to the client's specific concerns. Providing Internet sites (Choice A) may lead to unreliable information, and a drug reference book (Choice B) may not address individualized questions. While the written instructions may contain information (Choice C), they may not cover all potential queries the client might have, making direct contact with the healthcare provider the most appropriate option.
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