NCLEX NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. A newly diagnosed client with human immunodeficiency virus (HIV) comments to the nurse, 'There are so many rotten people around. Why couldn’t one of them get HIV instead of me?' Which statement is the nurse‘s best response?
- A. 'I can understand why you are afraid of dying.'
- B. 'It seems unfair that you contracted this disorder.'
- C. 'Do you really wish this disorder on someone else?'
- D. 'Have you thought of speaking with your religious adviser?'
Correct answer: 'It seems unfair that you contracted this disorder.'
Rationale: The client is expressing feelings of unfairness and questioning why they have HIV. The nurse's best response is to acknowledge the client's emotions. Choice B, 'It seems unfair that you contracted this disorder,' reflects empathy and validates the client's feelings, which can help them move towards acceptance. Choice A, 'I can understand why you are afraid of dying,' introduces the topic of death, which may not be the primary concern at this stage. Choice C, 'Do you really wish this disorder on someone else?' is judgmental and could induce guilt in the client. Choice D, 'Have you thought of speaking with your religious adviser?' deflects the conversation and does not address the client's current emotional needs.
2. A healthcare provider calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the healthcare provider most likely observed?
- A. The patient is somnolent with decreased response to stimuli.
- B. The patient suddenly complains of chest pain and shortness of breath.
- C. The patient has developed a wet cough and the healthcare provider hears crackles on auscultation of the lungs.
- D. The patient has a fever, chills, and loss of appetite.
Correct answer: The patient suddenly complains of chest pain and shortness of breath.
Rationale: The correct answer is 'The patient suddenly complains of chest pain and shortness of breath.' Typical symptoms of pulmonary embolism include chest pain, shortness of breath, and severe anxiety. The physician should be notified immediately. Clinical signs and symptoms for pulmonary embolism are nonspecific; therefore, patients suspected of having pulmonary embolism—because of unexplained dyspnea, tachypnea, or chest pain or the presence of risk factors for pulmonary embolism—must undergo diagnostic tests until the diagnosis is ascertained or eliminated or an alternative diagnosis is confirmed. Choices A, C, and D describe symptoms that are not typically associated with a pulmonary embolism, making them incorrect.
3. After giving birth to her third child, a client tearfully says to the nurse, 'How much more can I give of myself?' Which principle would the nurse consider in the care of any new mother?
- A. It is easier to adjust to the first child than to later ones.
- B. Feeling anger and resentment toward a child is pathological.
- C. Some parents experience feelings of being overwhelmed by multiple children.
- D. Parents usually have inborn feelings of love and acceptance of their children.
Correct answer: Some parents experience feelings of being overwhelmed by multiple children.
Rationale: A parent’s feeling of being overwhelmed by multiple children is a normal response. It is vital to help parents realize this as a means of easing feelings of guilt and shame. The first child causes the greatest amount of adjustment in one’s life. It is common for parents to feel anger and resentment toward their children at times due to the challenges of parenting. Stating that parents usually have inborn feelings of love and acceptance of their children is a false generalization and may not hold true for everyone. Therefore, the most appropriate principle for the nurse to consider in this situation is that some parents may experience feelings of being overwhelmed by multiple children.
4. A client who is in a late stage of pancreatic cancer intellectually understands the terminal nature of the illness. Which behaviors indicate the client is emotionally accepting the impending death?
- A. Revising the client’s will and planning a visit to a friend
- B. Alternating between crying and talking openly about death
- C. Seeking second, third, and fourth medical opinions
- D. Refusing to follow treatments and stating they won’t help anyway
Correct answer: Revising the client’s will and planning a visit to a friend
Rationale: Revising the will and planning a visit to a friend are indicative of emotional acceptance of impending death as they demonstrate realistic, productive, and constructive ways of using the remaining time. Alternating between crying and talking openly about death may suggest depression rather than acceptance. Seeking multiple medical opinions shows disbelief, denial, or desperation rather than acceptance. Refusing treatments and stating they won’t help reflects anger and hopelessness, not acceptance.
5. Patients who cannot move in their bed on their own should be turned at least ________________.
- A. once a day
- B. twice a day
- C. every 2 hours
- D. every 4 hours
Correct answer: every 2 hours
Rationale: Patients who are unable to move in bed are at high risk of developing pressure ulcers and skin breakdown due to prolonged pressure on specific body areas. Turning these patients at least every 2 hours is crucial to relieve pressure, improve circulation, and prevent skin damage. More frequent turning may be necessary for patients with specific needs, such as those who are incontinent of urine and require additional care. Turning patients less frequently, such as once a day, twice a day, or every 4 hours, increases the risk of developing pressure ulcers and other complications. Therefore, the correct answer is to turn patients who cannot move in their bed on their own every 2 hours.
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