NCLEX-RN
Psychosocial Integrity NCLEX Questions
1. A female client who is undergoing infertility testing is taught how to examine her cervical mucus. After listening to the instructions, the client says, 'That sounds gross. I don't think I can do it.' Which conclusion would the nurse make from this statement?
- A. The client is unduly fastidious.
- B. The client feels that having a baby is not that important.
- C. The client may be uncomfortable with performing manual examination of the genitals.
- D. The client is afraid that she is the cause of the infertility.
Correct answer: C
Rationale: The client's statement expressing discomfort with the procedure indicates a potential unease with performing a manual examination of her genitals. It is not uncommon for individuals to feel uncomfortable or anxious about such intimate procedures. The nurse should explore this further with the client to address any concerns or fears. The option stating that the client is unduly fastidious lacks evidence and is not supported by the client's statement. The assumption that the client does not value having a baby is not warranted based on the given statement. While self-blame is a common emotional response in cases of infertility, the client's statement does not directly suggest this as the primary concern in this scenario.
2. A client who just had a bilateral mastectomy is preparing to talk about body changes. Which of the following actions of the nurse is most appropriate during this discussion?
- A. Provide a room that offers minimal distractions
- B. Ask closed-ended questions to allow the client to think about her situation
- C. Write detailed notes during the conversation to track important information
- D. Ask personal questions about the client's background to determine how the procedure has affected her self-concept
Correct answer: A
Rationale: When preparing to discuss sensitive topics such as body changes post-bilateral mastectomy, it is crucial to create a conducive environment. Providing a room with minimal distractions allows the client to feel comfortable, safe, and more likely to open up about personal feelings without interruptions. This setting fosters open communication between the nurse and client, facilitating a more empathetic and supportive interaction. Closed-ended questions (Choice B) may limit the client's ability to express emotions fully. Writing detailed notes (Choice C) during the conversation may distract the nurse from actively listening and being present for the client. Asking personal questions about the client's background (Choice D) may not be appropriate during such a vulnerable discussion and could potentially create discomfort for the client.
3. Which approach is best to use with a client who is angry and agitated?
- A. Confront the client about the behavior.
- B. Turn on the television to distract the client.
- C. Maintain a calm, consistent approach with the client.
- D. Explain to the client why the behavior is unacceptable.
Correct answer: C
Rationale: When dealing with an angry and agitated client, it is crucial to maintain a calm and consistent approach. Consistency allows the client to predict the caregiver's behavior, which can help reduce their anxiety and agitation. Confronting the client about their behavior may escalate the situation and increase their anger. Using distractions like turning on the television is not addressing the underlying issue and may not be effective in calming the client. Explaining to the client why their behavior is unacceptable is not suitable in the moment of agitation, as the client may not be in a state to attend to logical explanations and perceived criticisms should be avoided to prevent further escalation.
4. Which of these is a one-on-one communication between the nurse and another person?
- A. Small-group communication
- B. Intrapersonal communication
- C. Interpersonal communication
- D. Transpersonal communication
Correct answer: C
Rationale: Interpersonal communication is a one-on-one interaction between a nurse and another person that often occurs face-to-face. It involves direct communication between two individuals. Small-group communication involves interaction among a small number of people, not just one-on-one. Intrapersonal communication is internal communication that occurs within an individual's mind. Transpersonal communication involves interactions within a person's spiritual domain, which is beyond individual one-on-one communication.
5. Which action often triggers an episode of violence or aggression in a patient with a psychiatric diagnosis involving violent behavior?
- A. Obtaining a history
- B. Asking for input into care
- C. Enforcing rules
- D. Taking a walk
Correct answer: C
Rationale: Enforcing rules is often a trigger for patients with psychiatric diagnoses involving violent behavior. Limit-setting or denying patient demands can be perceived as control and intimidation, leading to aggressive responses. Nursing staff must respond calmly and professionally to prevent escalation. Avoiding such patients or matching their emotions can worsen the situation. Therefore, enforcing rules can provoke violent episodes in these patients.
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