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. A client states that she is angry and feels rejected by her boyfriend. Which action would the nurse encourage?
- A. Call the boyfriend to work things out.
- B. Avoid confronting the boyfriend.
- C. Date new people whenever possible.
- D. Learn to constructively vent anger.
Correct answer: D
Rationale: The correct answer is to encourage the client to learn to constructively vent anger. Coping mechanisms, such as venting anger, can help the client address feelings of rejection. Calling the boyfriend to work things out is offering unsolicited advice and may not be effective in managing emotions. Avoiding confronting the boyfriend may reduce anxiety temporarily but will not assist in resolving the underlying issues. Encouraging the client to date new people whenever possible is not appropriate at this stage, as it is essential for the client to work through the current crisis before considering new relationships.
3. The health care provider has changed a client's prescription from the PO to the IV route of administration. The nurse should anticipate which change in the pharmacokinetic properties of the medication?
- A. The client will experience increased tolerance to the drug's effects and may need a higher dose.
- B. The onset of action of the drug will occur more rapidly, resulting in a more rapid effect.
- C. The medication will be more highly protein-bound, increasing the duration of action.
- D. The therapeutic index will be increased, placing the client at greater risk for toxicity.
Correct answer: B
Rationale: When changing the route of administration from PO to IV, the absorption process is bypassed, leading to a more rapid onset of action of the medication and consequently a quicker effect. Choices A, C, and D are incorrect. Increased drug tolerance and higher doses are not typical outcomes of changing the route of administration. Protein binding does not increase with a change to IV administration; rather, it is the bioavailability and onset of action that are affected. Moreover, an increased therapeutic index reduces the risk of drug toxicity, contrary to what is stated in choice D.
4. A client who has multiple sclerosis is admitted to the hospital with increasingly frequent and severe exacerbations. One day, the client's partner confides to the nurse, 'Life is getting very hard and depressing, and I am upset with myself for thinking about a nursing home.' After listening to the partner's concerns, which response would the nurse make?
- A. 'Joining a support group of people who are coping with this situation may be helpful.'
- B. 'You may be able to decrease your feelings of guilt by seeking counseling.'
- C. 'It would be helpful if you became involved in volunteer work at this time.'
- D. 'I recognize it's hard to deal with, but try to remember that this, too, shall pass.'
Correct answer: A
Rationale: Joining a support group of individuals facing similar circumstances can provide valuable support and the opportunity to share experiences, making it the most appropriate response. The response suggesting counseling to decrease feelings of guilt is premature because the partner did not directly express guilt and it may not be the most immediate need. Suggesting involvement in volunteer work at this time fails to address the partner's current emotional distress and may come across as dismissive. Offering false reassurance by stating 'this, too, shall pass' does not validate the partner's feelings and minimizes the seriousness of their concerns.
5. Your patient has been confused for years. Your patient can be best described as having a chronic ___________ disorder.
- A. physical
- B. psychotic
- C. thinking
- D. palliative
Correct answer: C
Rationale: Patients who experience long-term confusion often have a chronic thinking, or cognitive, disorder. Alzheimer's disease is a prime example of a disorder that results in prolonged confusion and memory loss. Choice A, 'physical', is incorrect as the issue described is related to cognitive functioning, not physical health. Choice B, 'psychotic', refers to a severe mental disorder characterized by a loss of contact with reality, which is not the primary issue presented in the scenario. Choice D, 'palliative', is not relevant as it pertains to specialized medical care for individuals with serious illnesses, focusing on providing relief from symptoms and stress rather than managing chronic confusion.
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