on the first postpartum day a client whose infant is rooming in asks the nurse to return her baby to the nursery and bring the baby to her only at fee
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Nursing Elites

NCLEX-RN

Psychosocial Integrity NCLEX Questions

1. On the first postpartum day, a client whose infant is rooming in asks the nurse to return her baby to the nursery and bring the baby to her only at feeding times. Which response would the nurse provide?

Correct answer: A

Rationale: Stating that it seems that the client has changed her mind opens communication and allows the client to verbalize her thoughts and feelings. This response acknowledges the client's request without being judgmental. Stating that the client is having difficulty caring for the baby is presumptuous and could make the client defensive. Informing other nurses of the client's decision without exploring the reasons behind it may not address the client's concerns. Although the client may be tired, assuming this without further discussion may overlook the client's true feelings and needs, hindering effective communication and support.

2. For a client with obsessive-compulsive disorder, which reaction is most likely to occur when the performance of a ritual is interrupted?

Correct answer: A

Rationale: When a client with obsessive-compulsive disorder is interrupted while performing a ritual, the most likely reaction is anxiety. The compulsive ritual serves as a coping mechanism to control anxiety, so any disruption to this ritual can heighten the individual's anxiety levels. Hostility is typically part of the disorder itself and not a direct reaction to the interruption of the ritual. Aggression may occur only if anxiety escalates to a panic level, leading to overt anger expression. Withdrawal is not a common behavioral pattern associated with obsessive-compulsive disorder and is not a typical reaction to ritual interruption.

3. A child is undergoing chemotherapy to treat a neuroblastoma, stage IV, and had his first chemotherapy session last week. He arrives with his mother for this week's session. How would the nurse greet the child?

Correct answer: A

Rationale: The most appropriate way for the nurse to greet the child is by asking, 'How did you feel after your last treatment?' This question allows the child to share their experience voluntarily, empowering them to feel in control of the conversation. It also demonstrates empathy and a caring attitude. Option B, 'What are your thoughts on the treatment so far?' is broad and may not address the child's immediate feelings after the last session. Option C, 'Did you experience any side effects after the last session?' focuses solely on side effects and may predispose the child to think negatively. Option D, 'Are you ready for the next round of treatment?' does not address the child's current well-being or feelings, missing an opportunity for emotional support and connection.

4. What is a common reason why clients abuse alcohol?

Correct answer: A

Rationale: Clients often abuse alcohol to blunt reality. Alcohol, by depressing the central nervous system and distorting or altering reality, can reduce anxiety. It is not primarily used to precipitate euphoria; instead, it may lead to mood swings, impaired judgment, and aggressive behavior. While alcohol can be used as a social lubricant, individuals with alcohol use disorder often drink in isolation. Moreover, excessive alcohol consumption can result in inappropriate and aggressive behaviors that hinder social interactions. It's important to note that alcohol is a depressant, unlike stimulants such as amphetamines and cocaine.

5. A client states that she is angry and feels rejected by her boyfriend. Which action would the nurse encourage?

Correct answer: D

Rationale: The correct answer is to encourage the client to learn to constructively vent anger. Coping mechanisms, such as venting anger, can help the client address feelings of rejection. Calling the boyfriend to work things out is offering unsolicited advice and may not be effective in managing emotions. Avoiding confronting the boyfriend may reduce anxiety temporarily but will not assist in resolving the underlying issues. Encouraging the client to date new people whenever possible is not appropriate at this stage, as it is essential for the client to work through the current crisis before considering new relationships.

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