NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which factor is most critical for a single mother of 2 children who recently lost her job and does not know what to do?
- A. Developmental history of children
- B. Available situational supports
- C. Underlying unconscious conflict
- D. Willingness to restructure lifestyle
Correct answer: B
Rationale: In a crisis intervention, the priority is to identify available situational supports, such as family, friends, community resources, and social services, that can help the single mother and her children during this difficult time. Understanding the developmental history of the children may be important to assess their needs, but it is not the most critical factor in this immediate crisis. Exploring underlying unconscious conflicts is more suited for long-term therapy rather than crisis intervention. While the willingness to restructure lifestyle may eventually be necessary, the immediate focus should be on finding support systems to address the current crisis.
2. Nursing behaviors associated with the implementation phase of the nursing process are concerned with:
- A. participating in the mutual identification of patient outcomes.
- B. gathering accurate and sufficient patient-centered data.
- C. comparing patient responses and expected outcomes.
- D. carrying out interventions and coordinating care.
Correct answer: D
Rationale: During the implementation phase of the nursing process, nurses focus on executing interventions and coordinating care. This involves utilizing available resources, performing necessary interventions, exploring alternatives when needed, and collaborating with other healthcare team members to ensure comprehensive care delivery. Choice A is incorrect as it pertains more to the planning phase where patient outcomes are identified. Choice B is incorrect as it relates to data collection, which is primarily a part of the assessment phase. Choice C is incorrect as it involves evaluating patient responses against expected outcomes, which is part of the evaluation phase.
3. What feeling is likely to result from withdrawn behavior?
- A. Anger
- B. Paranoia
- C. Loneliness
- D. Boredom
Correct answer: C
Rationale: Withdrawn behavior involves avoiding social interactions and isolating oneself. This isolation can lead to feelings of loneliness as the individual lacks connection and companionship. While anger or paranoia may contribute to withdrawal, loneliness is a common emotional consequence of prolonged social isolation. Boredom may also arise from withdrawal if meaningful activities and social engagements are reduced.
4. Which client is most likely to be at risk for spiritual distress?
- A. Roman Catholic woman considering an abortion
- B. Jewish man considering hospice care for his wife
- C. Seventh-Day Adventist who needs a blood transfusion
- D. Muslim man who needs a total knee replacement
Correct answer: A
Rationale: The correct answer is the Roman Catholic woman considering an abortion. In the Roman Catholic faith, abortion is strictly prohibited, so making a decision regarding abortion can bring about spiritual distress. The Jewish faith does not have restrictions on hospice care. It is Jehovah's Witnesses, not Seventh-Day Adventists, who do not accept blood transfusions due to religious beliefs. Additionally, there are no religious prohibitions against joint replacement in the Muslim faith.
5. Why might a nurse manager suggest avoiding therapeutic group work for a client with schizophrenia who has paranoid delusions?
- A. Individuals with this disorder respond well to small therapeutic groups.
- B. Therapeutic group work tends to be threatening to individuals who are suspicious.
- C. Compliance with unit rules and medication regimens increases as therapeutic group involvement increases.
- D. Involvement in small therapeutic groups may decrease the regression and dependency associated with institutionalization.
Correct answer: B
Rationale: The nurse manager would suggest avoiding therapeutic group work for a client with schizophrenia who has paranoid delusions because individuals who are suspicious find group settings threatening. Paranoid individuals struggle in groups as they may not trust others enough to engage effectively and tolerate the necessary interactions for group therapy. Therefore, the correct answer is that therapeutic group work tends to be threatening to individuals who are suspicious. Choices A, C, and D are incorrect. While some individuals with schizophrenia may respond well to small therapeutic groups, those with paranoid delusions may find them threatening. Compliance with unit rules and medication regimens may not necessarily increase with group therapy, especially for acutely ill psychiatric clients not ready to accept reality. Involvement in small therapeutic groups is not primarily aimed at decreasing regression and dependency associated with institutionalization, making it an inappropriate option for the client's specific needs.
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