NCLEX NCLEX-RN
Psychosocial Integrity NCLEX Questions
1. A parent of a young child says, 'I’m so upset! The doctor prescribed an antidepressant!' Which response is best?
- A. 'Tell me more about what’s bothering you.'
- B. 'Weren’t you told about the need for the medication?'
- C. 'I’ll notify the healthcare provider about your concerns.'
- D. 'Maybe the medication is for attention deficit disorder.'
Correct answer: 'Tell me more about what’s bothering you.'
Rationale: The best response in this situation is to express empathy and encourage the parent to share more about their concerns. Option A ('Tell me more about what’s bothering you.') allows the nurse to show understanding and gather more information to address the parent's distress effectively. Option B ('Weren’t you told about the need for the medication?') is confrontational and may make the parent defensive, hindering effective communication. Option C ('I’ll notify the healthcare provider about your concerns.') is premature; the nurse should first assess the parent's feelings before deciding on further actions. Option D ('Maybe the medication is for attention deficit disorder.') assumes without clarification, which is not appropriate; the nurse should validate the prescription before suggesting alternative reasons.
2. A toddler is 26 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in?
- A. Trust vs. mistrust
- B. Initiative vs. guilt
- C. Autonomy vs. shame and doubt
- D. Intimacy vs. isolation
Correct answer: C: Autonomy vs. shame and doubt
Rationale: The correct stage for a toddler who is 26 months old, according to Erik Erikson's stages of psychosocial development, is Autonomy vs. shame and doubt. This stage occurs between 18 months to 3 years of age. During this stage, children are focused on developing a greater sense of control and independence. Choice A, Trust vs. mistrust, is the first stage occurring from birth to 18 months, where infants learn to trust or mistrust their caregivers based on their care. Choice B, Initiative vs. guilt, is the third stage occurring from 3 to 5 years, where children start to assert themselves more. Choice D, Intimacy vs. isolation, is a stage occurring in adulthood, not relevant to a toddler's development.
3. Which parental statement would the nurse recognize as the appropriate application of time-out when disciplining a 4-year-old?
- A. I send my child to their bedroom for misbehaving.
- B. We limit time-out to 4 minutes per incident.
- C. Putting my child in a dark closet for time-out is very effective.
- D. I explain the reason for the time-out before and after disciplining my child.
Correct answer: D: I explain the reason for the time-out before and after disciplining my child.
Rationale: The correct answer is to explain the reason for the time-out before and after disciplining the child. This approach reinforces the child’s association of the time-out with the undesirable behavior, helping the child learn to control those behaviors. Sending a child to their bedroom may lead to negative associations with bedtime or be ineffective if the child enjoys spending time in their bedroom. Time-out should ideally be limited to 1 minute per year of age, so a time-out for a 4-year-old should be limited to 4 minutes. Placing a child in a dark closet can create fear and damage the child’s trust in their parents as a source of safety, making it an inappropriate and harmful approach. Even if this method seems effective in the short term, the potential long-term consequences outweigh any immediate benefits.
4. An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time?
- A. Prone position
- B. On the stomach
- C. Left lateral position
- D. Right lateral position
Correct answer: Left lateral position
Rationale: After surgical repair of a cleft lip on the right side, the nurse should position the infant carefully to ensure comfort and prevent complications. Placing the infant in the prone position or on the stomach is not recommended as it may cause rubbing of the surgical site against the mattress. The optimal position for the infant is the left lateral position, away from the surgical repair site, to minimize the risk of trauma. Placing the infant on the right lateral position would be contraindicated as it is on the side of the repair. Additionally, positioning the infant upright on the back can help prevent airway obstruction by secretions, blood, or the tongue. Therefore, the correct choice is to place the infant in the left lateral position to promote safety and comfort post cleft lip surgery.
5. In a clinic in a primarily African American community, a higher incidence of uncontrolled hypertension is noted in patients. To correct this health disparity, what should the nurse do first?
- A. Initiate a regular home-visit program by clinic nurses.
- B. Schedule teaching sessions about low-salt diets at community events.
- C. Assess the perceptions of community members about the care at the clinic.
- D. Obtain low-cost antihypertensive drugs using government grant funding.
Correct answer: Assess the perceptions of community members about the care at the clinic.
Rationale: To address the higher incidence of uncontrolled hypertension in the primarily African American community, the nurse should first assess the perceptions of community members about the care at the clinic. Understanding the community's perspective can provide valuable insights into the reasons behind the health disparity. Initiating a regular home-visit program or scheduling teaching sessions about low-salt diets are important interventions but should come after gathering information on community perceptions. Obtaining low-cost antihypertensive drugs is not the initial priority; understanding community perspectives is crucial for developing effective interventions.
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