NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. The client is a 35-year-old multiparous individual scheduled for a tubal ligation. The nurse assesses the client's emotional response to the planned procedure. Which factor in the client's history will contribute to the healthy resolution of any emotional problem associated with sterilization?
- A. Belief that the surgery will relieve her monthly dysmenorrhea
- B. Knowledge that her partner does not want to have any more children
- C. Feeling that her family is complete and she now has the children she planned for
- D. Recovery from her previous complicated birth and a desire to avoid another birth
Correct answer: C
Rationale: The correct answer is feeling that her family is complete and she now has the children she planned for. Many couples in their 30s who feel that their families are complete choose sterilization as their method of contraception. Sterilization by means of tubal ligation should not be expected to have an effect on dysmenorrhea. The decision to undergo sterilization should be the individual's own choice and should not be influenced by others, including partners. Decisions regarding sterilization should ideally be made when the individual is not under stress, such as after recovery from a previous complicated birth. Therefore, the key factor contributing to a healthy resolution of emotional issues related to sterilization is the feeling of family completeness and achieving the planned number of children.
2. 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: A
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.
3. The mother of a 5-month-old is being educated about her baby's nutrition by the nurse. Which statement by the mother indicates the need for further teaching?
- A. ''I'm going to try feeding my baby some rice cereal.''
- B. ''When he wakes at night for a bottle, I feed him.''
- C. ''I dip his pacifier in honey so he'll take it.''
- D. ''I keep formula in the refrigerator for 24 hours.''
Correct answer: C
Rationale: The correct answer is ''I dip his pacifier in honey so he'll take it.'' This statement indicates a need for further teaching because honey should be avoided in infants due to the risk of infant botulism. Honey may contain spores of Clostridium botulinum, which can lead to serious illness in infants as they lack the necessary digestive enzymes to eliminate the spores. Feeding rice cereal, responding to night-time feedings, and storing formula in the refrigerator are appropriate practices for infant care, indicating understanding of the instructions.
4. Which nursing intervention would be provided to a hospitalized client during the identity versus role confusion stage?
- A. Choosing creative ways to promote social participation
- B. Providing information to the client about the treatment plan
- C. Encouraging the client to participate actively in treatment procedures
- D. Involving the client's partners or family members in the caring process
Correct answer: B
Rationale: During the identity versus role confusion stage, which occurs during adolescence or puberty, it is essential for the nurse to empower hospitalized adolescents by providing them with sufficient information about their treatment plan. This approach enables the clients to actively participate in decision-making regarding their care. Choosing creative ways to promote social participation is more aligned with assisting clients during the generativity versus self-absorption and stagnation stage, where fostering social engagement can contribute to a sense of fulfillment. Involving the client's partners or family members in the caring process is typically beneficial during the intimacy versus isolation stage to create a strong support system for the client. Encouraging active participation in treatment procedures is more relevant to the industry versus inferiority stage, ensuring that the hospitalized client engages effectively in their care.
5. A client who is to undergo dilation and curettage and conization of the cervix for cancer appears tense and anxious. Which approach would the nurse use to support the client emotionally?
- A. Explaining that these procedures are considered minor surgery
- B. Asking whether something is troubling the client and whether she'd like to talk about it
- C. Stating that the procedures are routine and asking what the client is really worried about
- D. Explaining that everyone is fearful before the surgery even though there is little reason to worry
Correct answer: B
Rationale: The correct approach for the nurse to support the client emotionally is to ask whether something is troubling the client and if she would like to talk about it. This approach acknowledges the client's anxiety and encourages communication without dismissing her feelings. Option A, explaining that the procedures are minor surgery, may invalidate the client's emotions. Option C assumes the client is worried about something specific, which may not be the case, leading to miscommunication. Option D provides false reassurance and may hinder open communication by dismissing the client's feelings as unwarranted.
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