which approach would the nurse use when a manipulative client who uses acting out behaviors asks the nurse to talk when the nurse is orienting a new c

NCLEX-RN

Psychosocial Integrity NCLEX Questions

1. What approach should the nurse use when a manipulative client who uses acting-out behaviors asks the nurse to talk while the nurse is orienting a new client to the unit?

A. Suggest that the client requesting attention speak with another staff member.
B. Leave the new client, saying, 'I'll talk with the other client until things calm down.'
C. Introduce the two clients and suggest that the client join them on a tour of the facility.
D. Say to the interrupting client, 'I'll be back to talk with you after I orient this new client.'

Correct answer: D

Rationale: The nurse should respond to the manipulative client who uses acting-out behaviors by setting realistic limits on behavior without rejecting the client. Therefore, the correct approach is to say to the interrupting client, 'I'll be back to talk with you after I orient this new client.' This response acknowledges the client's request while prioritizing the needs of the new client and setting appropriate boundaries. Choices A, B, and C are incorrect. Suggesting that the client speak with another staff member would be a rejection of the client, not the behavior. Leaving the new client to attend to the manipulative client would encourage further manipulation and disrupt the orientation process for the new client. Introducing the two clients and suggesting a tour is inconsistent with setting limits and does not address the manipulative behavior being displayed.

2. According to psychodynamic theory, what purpose do delusions serve?

A. Delusions are a defense against anxiety caused by real or imagined threats.
B. Magical thinking is a delusion that ensures desirable outcomes.
C. Delusions are a method of dealing with and interpreting external stimuli.
D. Subconsciously, delusions are a way to safely express anger and hostility.

Correct answer: A

Rationale: According to psychodynamic theory, delusions serve as a defense mechanism against anxiety triggered by real or perceived threats. Delusions are the individual's unconscious way of protecting themselves from overwhelming feelings of anxiety. Magical thinking, on the other hand, involves believing that one's thoughts can influence external events. This is not the same as delusions. Delusions are not a way of interpreting external stimuli but rather a defense mechanism. Expressing anger and hostility is typically associated with defense mechanisms like displacement or projection, not delusions.

3. An older woman has lived alone since the death of her husband 10 years ago, and she has a long list of vague complaints. Which assessment is the priority for the home health nurse to perform?

A. Assess for feelings of loneliness and isolation.
B. Determine if the client has unresolved grief.
C. Determine if there are safety issues.
D. Ask about the availability of support systems.

Correct answer: C

Rationale: The priority assessment for the home health nurse in this scenario is to determine if there are safety issues. The client is an older woman living alone with a long list of vague complaints, indicating several risk factors. Ensuring her safety should be the primary concern. While assessing for feelings of loneliness, isolation, or grief is important, ensuring the client's safety takes precedence due to her vulnerable situation. Although assessing the availability of support systems is essential in a home health assessment, safety issues must be addressed first given the client's profile.

4. Which psychosocial attribute plays an important role in the development of a healthy personality from birth to 1 year of age?

A. Initiative versus guilt
B. Trust versus mistrust
C. Autonomy versus shame
D. Industry versus inferiority

Correct answer: B

Rationale: According to Erikson's theory of psychosocial development, the first attribute that helps develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is observed at 3 to 6 years of age, when children explore their surroundings and may experience guilt if their actions conflict with parental expectations. Autonomy versus shame occurs between 1 and 3 years of age, as children develop motor skills and new activities, with shame emerging if they feel self-conscious. Industry versus inferiority is evident in children aged 6 to 12 years, where successful task completion fosters a sense of industry, while excessive expectations can lead to feelings of inferiority. Therefore, the correct attribute for a healthy personality development from birth to 1 year of age is trust versus mistrust.

5. Which is an example of an intentional tort?

A. Negligence
B. Malpractice
C. Breach of duty
D. False imprisonment

Correct answer: D

Rationale: False imprisonment is a clear example of an intentional tort where one person deliberately confines another without lawful justification. It involves intentional, wrongful restraint of a person's freedom of movement. Negligence, on the other hand, is an unintentional tort that occurs when someone fails to exercise reasonable care, resulting in harm to others. Malpractice, which involves professional negligence, is also classified as an unintentional tort as it is a failure to meet the standard of care expected in a particular profession. Breach of duty, while a legal concept, is not an example of an intentional tort. It refers to a failure to fulfill a legal obligation or duty owed to another party, often leading to legal consequences, but it is not categorized as an intentional tort.