which action would the nurse take to minimize agitation in a disturbed client
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Nursing Elites

NCLEX-RN

Psychosocial Integrity NCLEX Questions

1. What action would be most appropriate for the nurse to minimize agitation in a disturbed client?

Correct answer: C

Rationale: The most appropriate action to minimize agitation in a disturbed client is to limit unnecessary interactions. This approach helps reduce stimulation, thus decreasing agitation. Constant staff contact can lead to increased stimulation and agitation. Increasing environmental sensory stimulation can overwhelm the client's senses and escalate agitation. Discussing suspicions may not be beneficial as not all disturbed clients are suspicious and the client may not be in a state to engage in such discussions effectively.

2. The client is 5 feet from the bathroom door when he states, 'I feel faint.' Before the nurse can get the client to a chair, the client starts to fall. What is the priority action for the nurse to take?

Correct answer: D

Rationale: The priority action for the nurse is to gently lower the client to the floor (Option D). This action is crucial to prevent injury to both the client and the nurse. Lowering the client to the floor should be done when the client is unable to support his own weight, ensuring a safe position to prevent falls. Checking the client's carotid pulse (Option A) is important, but it should be performed after ensuring the client's safety. Encouraging the client to get to the toilet (Option B) is impractical as the client is already falling. Calling for help in a loud voice (Option C) may cause chaos and alarm other clients, making it a less suitable immediate action in this scenario.

3. According to the CDC, which of the following age groups is most likely to meet the criteria for major depression?

Correct answer: D

Rationale: According to the CDC, individuals aged 45-64 years are most likely to meet the criteria for major depression. While patients in the 18-24 year age group are more likely to report symptoms of depression, when it comes to major depression, the prevalence is higher in the 45-64 year age group. Choices A, B, and C are incorrect because the CDC indicates that major depression is most prevalent in the 45-64 year age group.

4. How is the secondary use of data from the 2000 census classification system utilized to address disparities in mental health care along racial-ethnic lines?

Correct answer: D

Rationale: The census classification system categorizes individuals based on racial and ethnic descriptions. Utilizing this data helps in identifying health disparities and assessing how the health care needs of ethnic populations are being addressed. Option A is incorrect because the primary focus is on analyzing healthcare needs met, not providing care. Option B is incorrect as the census does not encompass every single racial and ethnic group in the United States. Option C is incorrect as the census is not designed to investigate the reasons behind disparities, but rather to quantify and analyze them.

5. When bathing an uncircumcised boy older than 3 years, which action should the nurse take?

Correct answer: C

Rationale: When bathing an uncircumcised boy older than 3 years, it is essential to gently retract the foreskin to cleanse the penis. This helps in preventing the buildup of bacteria and maintaining good hygiene. Reminding the child to clean his genital area (Option A) may not be effective due to the child's cognitive development level. Perineal care should not be deferred (Option B) as it is necessary for maintaining hygiene at any age. Asking the parents why the child is not circumcised (Option D) is not relevant to the immediate care required during bathing.

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