NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which behavior is most typical for clients with borderline personality disorder?
- A. Arrogant
- B. Eccentric
- C. Impulsive
- D. Dependent
Correct answer: C
Rationale: The correct answer is 'Impulsive.' Clients with borderline personality disorder often exhibit impulsive, potentially self-damaging behaviors. Arrogance is more characteristic of narcissistic personality disorder, eccentric behavior aligns with schizotypal personality disorder, and dependent behavior is typical of dependent personality disorder. Therefore, the key feature of borderline personality disorder is impulsivity.
2. 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
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.
3. Which consideration is the most accurate when applying the principles of mental health?
- A. Emotionally ill individuals may initially reject psychological support from family or others.
- B. People with emotional illnesses may experience challenges in problem-solving.
- C. Mental illness is not solely characterized by signs and symptoms of socially inappropriate behavior.
- D. Emotional health is promoted when there is a sense of mastery of self and the environment.
Correct answer: D
Rationale: Emotional health is enhanced when an individual feels a sense of control over themselves and their surroundings, fostering security, reducing anxiety, and promoting optimal functioning. While some emotionally ill individuals may reject help initially, many are in distress and acknowledge the need for psychological support. Some seek care based on positive past experiences or the attention received. Additionally, individuals with excellent cognitive function may face challenges in problem-solving due to emotional or psychological barriers. Not all individuals with mental illness exhibit socially inappropriate behavior; it is a misconception that mental illness is solely characterized by such signs and symptoms. Therefore, the most accurate consideration among the choices is that emotional health thrives when there is a feeling of mastery over oneself and the environment.
4. While reviewing the side effects of a newly prescribed medication, a 72-year-old client notes that one of the side effects is a reduction in sexual drive. Which is the best response by the nurse?
- A. How will this affect your present sexual activity?
- B. How active is your current sex life?
- C. How has your sex life changed as you have become older?
- D. Tell me about your sexual needs as an older adult.
Correct answer: A
Rationale: The best response in this scenario is option A, 'How will this affect your present sexual activity?' This response directly addresses the client's concern and allows them to express their thoughts and feelings. Option B does not directly address the client's worry about the medication's side effect. Options C and D deviate from the client's immediate concern and are not as relevant in this situation.
5. While receiving a preoperative enema, a client starts to cry and says, 'I'm sorry you have to do this messy thing for me.' Which is the nurse's best response?
- A. I don't mind it.'
- B. 'You seem upset.'
- C. 'This is part of my job.'
- D. 'Nurses get used to this.'
Correct answer: B
Rationale: The nurse's best response in this situation is to acknowledge the client's emotional state, as it shows empathy and encourages further expression of feelings. Choice A, 'I don't mind it,' dismisses the client's emotions and does not address the underlying issue. Choice C, 'This is part of my job,' focuses on the task rather than the client's emotional needs. Choice D, 'Nurses get used to this,' minimizes the client's feelings and lacks empathy. By selecting choice B, 'You seem upset,' the nurse acknowledges the client's distress and opens the door for further communication and support.
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