NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. Which response would the nurse make when a client moans softly, 'Oh no, I'm next. They couldn't protect him, and they can't protect me,' after learning a recently discharged client committed suicide?
- A. ''The other person was a lot sicker than you are.''
- B. 'You seem to be afraid that you'll hurt yourself.''
- C. 'That was different. He was at home, but you're here.''
- D. 'There's no need to worry. You have a better support system.''
Correct answer: B
Rationale: The nurse would make the statement, 'You seem to be afraid that you'll hurt yourself.' This response acknowledges the client's emotional distress and opens up the opportunity for the client to discuss their feelings, showing empathy and understanding. Choice A, 'The other person was a lot sicker than you are,' dismisses the client's emotions and fails to address the underlying fear of self-harm. Choice C, 'That was different. He was at home, but you're here,' invalidates the client's concerns and does not encourage further discussion. Choice D, 'There's no need to worry. You have a better support system,' offers false reassurance and does not address the client's expressed fear, missing an opportunity for therapeutic communication.
2. A client who has undergone a mastectomy because of breast cancer is now undergoing chemotherapy, which has caused hair loss. The client states, 'I feel like I've lost my sense of power.' Which response would the nurse give?
- A. 'Hair does not empower a person.'
- B. 'Losing power seems important to you.'
- C. Knowledge is power; I'll give you some pamphlets to read.'
- D. 'Hair loss is common; it will grow back, so you should not worry.'
Correct answer: B
Rationale: The correct response is, 'Losing power seems important to you.' This response acknowledges the client's feelings and provides an opportunity for further discussion. Choice A is confrontational and dismissive, potentially shutting down communication. Choice C offers pamphlets, which may be seen as dismissing the client's concerns and avoiding engaging in a conversation. Choice D minimizes the client's feelings and may discourage further expression of emotions. By choosing option B, the nurse shows empathy and encourages the client to explore their emotions in a supportive environment.
3. Which approach would the healthcare provider use when managing the care of a client diagnosed with generalized anxiety disorder (GAD)?
- A. Creating an anxiety-free environment for the client
- B. Assisting the client with the development of healthy, adaptive coping mechanisms
- C. Avoiding triggers that produce anxiety in the client
- D. Providing reinforcement that the client's anxiety issues can be eliminated
Correct answer: B
Rationale: The healthcare provider would assist the client with the development of healthy, adaptive coping mechanisms. GAD is characterized by the maladaptive use of worrying as a coping mechanism. The ultimate goal is for the healthcare provider to help the client replace the ineffective worrying with effective, healthy coping mechanisms. Creating an anxiety-free environment is not feasible or recommended; the goal is to help the client learn to deal with anxiety in a healthy manner. While identifying triggers is important, avoiding all triggers that produce anxiety is often impractical. Providing reinforcement that anxiety issues can be eliminated is not appropriate as anxiety is a normal human experience that needs to be managed effectively rather than eliminated completely.
4. On the first postpartum day, a client whose infant is rooming in asks the nurse to return her baby to the nursery and bring the baby to her only at feeding times. Which response would the nurse provide?
- A. It seems that you've changed your mind about rooming in.
- B. I think you're having difficulty caring for the baby.
- C. All right. I'll inform the other nurses of your decision.
- D. You must be tired. I'll bring the baby back at feeding time.
Correct answer: A
Rationale: Stating that it seems that the client has changed her mind opens communication and allows the client to verbalize her thoughts and feelings. This response acknowledges the client's request without being judgmental. Stating that the client is having difficulty caring for the baby is presumptuous and could make the client defensive. Informing other nurses of the client's decision without exploring the reasons behind it may not address the client's concerns. Although the client may be tired, assuming this without further discussion may overlook the client's true feelings and needs, hindering effective communication and support.
5. Which priority action would the nurse manager use to help the nurse who may be experiencing burnout?
- A. Transfer the nurse to another unit in the facility.
- B. Help the nurse choose a position on a low-stress unit.
- C. Encourage the nurse to attend educational programs.
- D. Help the nurse identify personal responses to job stress.
Correct answer: D
Rationale: The correct priority action for the nurse manager to help a nurse experiencing burnout is to assist the nurse in identifying personal responses to job stress. This involves recognizing work stressors in the environment and evaluating coping strategies to determine their effectiveness. While transferring the nurse to another unit could be a solution, the initial focus should be on self-awareness and coping strategies. Choosing a position on a low-stress unit and attending educational programs can be beneficial in reducing burnout, but they are not the primary steps to address burnout when it occurs.
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