NCLEX NCLEX-PN
Psychosocial Integrity Nclex PN Questions
1. When assisting a client in gaining insight into anxiety, what should the nurse do?
- A. Help the client relate anxiety to specific triggers.
- B. Ask the client to describe events that precede increased anxiety.
- C. Instruct the client to practice relaxation techniques.
- D. Confront the client's resistive behavior.
Correct answer: Ask the client to describe events that precede increased anxiety.
Rationale: To assist a client in gaining insight into anxiety, it is crucial to identify triggers or events that lead to increased anxiety. This approach helps the client recognize causal factors contributing to their anxiety, promoting self-awareness and understanding. Choice A is incorrect because it should focus on triggers rather than specific behaviors. Choice C is incorrect as it emphasizes managing anxiety through relaxation techniques rather than understanding its roots. Choice D is incorrect as it addresses resistive behavior rather than exploring the causes of anxiety.
2. A healthcare professional is assisting with data collection of a client with suspected cholecystitis. Which finding does the healthcare professional expect to note if cholecystitis is present?
- A. Homan sign
- B. Murphy sign
- C. Blumberg sign
- D. McBurney sign
Correct answer: Murphy sign
Rationale: The correct answer is B: Murphy sign. The Murphy sign is an indicator of gallbladder disease. It involves the examiner placing fingers under the liver border while the client inhales. If the gallbladder is inflamed, it descends onto the fingers, causing pain. The Homan sign is associated with pain in the calf area upon sharp dorsiflexion of the foot, indicating deep vein thrombosis. The Blumberg sign is the presence of rebound tenderness on palpation of the abdomen, indicating peritoneal irritation. The McBurney sign is indicative of appendicitis, presenting as severe pain and tenderness upon palpation at McBurney's point in the right lower quadrant of the abdomen.
3. The nurse observes bilateral bruises on the arms of an elderly client in a long-term care facility. Which of the following questions should the nurse ask this client?
- A. “How did you get those bruises?”
- B. “Did someone grab you by your arms?”
- C. “Do you fall often?”
- D. “What did you bump against?”
Correct answer: “Did someone grab you by your arms?”
Rationale: When addressing suspected abuse, it is crucial to ask direct questions to determine the cause of injuries. Choice B is the most appropriate as it directly inquires about the possibility of someone grabbing the client's arms, which could indicate abuse. This question can help uncover potential abuse and provide necessary intervention. Choices A, C, and D are less direct and may not elicit the critical information needed to address abuse effectively. Clients often hesitate to report abuse due to feelings of shame and fear of retaliation, making a direct approach essential in such situations.
4. Diagnostic genetic counseling, for procedures such as amniocentesis and chorionic villus sampling, allows clients to make all of the following choices except:
- A. terminating the pregnancy.
- B. preparing for the birth of a child with special needs.
- C. accessing support services before the birth.
- D. completing the grieving process before the birth.
Correct answer: completing the grieving process before the birth.
Rationale: Diagnostic genetic counseling provides clients with important information to make informed decisions regarding their pregnancy. Clients can choose to terminate the pregnancy, prepare for the birth of a child with special needs, and access support services before the birth based on the genetic testing results. However, completing the grieving process before the birth is not a typical choice during genetic counseling. The grieving process, if needed, may extend beyond the prenatal period, especially if the findings are concerning or indicate potential issues. Therefore, completing the grieving process before the birth is the exception among the provided options.
5. When assessing a client's mobility status, the physical examination should start with:
- A. examining their gait.
- B. orienting to time, place, and person.
- C. performing the Romberg test.
- D. conducting the Tandem Walk test.
Correct answer: examining their gait.
Rationale: When assessing a client's mobility status, it is crucial to start by examining their gait. Gait assessment is usually conducted as the client walks into the room. Normal gait is described as smooth, flowing, and rhythmic without the need for assistive devices. Choices B, C, and D are incorrect as they do not represent the standard practice of beginning the assessment of mobility status with gait examination.
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