NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. What is the primary purpose served when an individual takes action to reduce anxiety?
- A. Reduction of tension
- B. Denial of the situation
- C. Avoidance of physical discomfort
- D. Resolution in decision-making
Correct answer: A
Rationale: The primary purpose of taking action to reduce anxiety is to alleviate emotional tension and prevent the exacerbation of anxiety symptoms. By reducing tension, anxiety levels decrease, leading to a sense of comfort, safety, and security. Denial of the situation is not the goal when addressing anxiety; rather, acknowledging and managing it is crucial. While physical discomfort may accompany anxiety, the focus is on alleviating the emotional aspect to mitigate physical manifestations. Although mild anxiety can sometimes improve decision-making skills, higher levels of anxiety typically impede cognitive functions, making resolution in decision-making less likely.
2. Which of the following individuals is at the highest risk of experiencing intimate partner violence?
- A. A 36-year-old woman who is recently divorced
- B. A 22-year-old man who is unemployed but living with friends
- C. A 20-year-old woman who grew up with a psychologically abusive father
- D. A 40-year-old man diagnosed with schizophrenia
Correct answer: C
Rationale: Intimate partner violence is a serious issue encompassing physical, psychological, or sexual abuse within an intimate relationship. Individuals who have experienced psychological abuse in their upbringing are at a higher risk of becoming victims themselves due to the normalization of abusive behaviors. While factors such as age, mental health conditions, and social support can contribute to vulnerability, growing up in an abusive environment can significantly heighten the risk of intimate partner violence. The other options, such as recent divorce (A), unemployment (B), and schizophrenia diagnosis (D), do not directly correlate with the same level of increased risk associated with a history of psychological abuse.
3. What is the priority nursing action to assist an anxious father in his concern about not bonding with his newborn?
- A. Encouraging the father to participate in a parenting class
- B. Providing time for the father to be alone with and get to know the baby
- C. Offering the father a demonstration on newborn diapering, feeding, and bathing
- D. Allowing time for the father to ask questions after viewing a film about a new baby
Correct answer: B
Rationale: The priority nursing action to assist an anxious father in his concern about not bonding with his newborn is providing time for the father to be alone with and get to know the baby. Time alone provides the opportunity for paternal-infant attachment and bonding, which can help reduce the father's anxiety. Encouraging the father to participate in a parenting class, although helpful, does not directly address the immediate need for bonding. Offering a demonstration on newborn care tasks like diapering, feeding, and bathing may not effectively address the father's anxiety at that moment, as he may not be ready to absorb such information. Allowing time for the father to ask questions after viewing a film about a new baby is a simplistic approach that may not adequately address the emotional needs and concerns of the father regarding bonding with his newborn.
4. Which approach is best to use with a client who is angry and agitated?
- A. Confront the client about the behavior.
- B. Turn on the television to distract the client.
- C. Maintain a calm, consistent approach with the client.
- D. Explain to the client why the behavior is unacceptable.
Correct answer: C
Rationale: When dealing with an angry and agitated client, it is crucial to maintain a calm and consistent approach. Consistency allows the client to predict the caregiver's behavior, which can help reduce their anxiety and agitation. Confronting the client about their behavior may escalate the situation and increase their anger. Using distractions like turning on the television is not addressing the underlying issue and may not be effective in calming the client. Explaining to the client why their behavior is unacceptable is not suitable in the moment of agitation, as the client may not be in a state to attend to logical explanations and perceived criticisms should be avoided to prevent further escalation.
5. Which instruction is most important for the nurse to include when teaching a client with limited mobility strategies to prevent venous thrombosis?
- A. Perform cough and deep breathing exercises hourly.
- B. Turn from side to side in bed at least every 2 hours.
- C. Dorsiflex and plantarflex the feet 10 times each hour
- D. Drink approximately 4 ounces of water every hour
Correct answer: C
Rationale: To reduce the risk of venous thrombosis, the nurse should instruct the client to perform dorsiflexion and plantar flexion exercises regularly. These exercises help promote venous return and prevent venous thrombus formation. Options A, B, and D are beneficial in managing other complications of immobility, such as atelectasis and pressure ulcers, but they are less effective in preventing venous thrombosis compared to dorsiflexion and plantar flexion exercises.
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