NCLEX-RN
Psychosocial Integrity NCLEX Questions
1. Which thought process would the nurse document the mental health client is experiencing after the client says, 'The FBI is out to kill me'?
- A. Hallucinations
- B. Error in judgment
- C. Delusion of persecution
- D. Self-accusatory delusion
Correct answer: C
Rationale: The nurse would document that the client is experiencing a delusion of persecution. A delusion of persecution is a fixed and firm belief of being harassed, in danger, or at the mercy of others, as illustrated by 'The FBI is out to kill me.' Hallucinations are perceived experiences that occur without actual sensory stimulation. Error in judgment refers to poor decision-making, not a distortion of reality like a delusion. A self-accusatory delusion involves accepting blame for an act that was never committed or a feeling that was never acted on. Therefore, the correct choice is 'Delusion of persecution.'
2. According to psychodynamic theory, what purpose do delusions serve?
- A. Delusions are a defense against anxiety caused by real or imagined threats.
- B. Magical thinking is a delusion that ensures desirable outcomes.
- C. Delusions are a method of dealing with and interpreting external stimuli.
- D. Subconsciously, delusions are a way to safely express anger and hostility.
Correct answer: A
Rationale: According to psychodynamic theory, delusions serve as a defense mechanism against anxiety triggered by real or perceived threats. Delusions are the individual's unconscious way of protecting themselves from overwhelming feelings of anxiety. Magical thinking, on the other hand, involves believing that one's thoughts can influence external events. This is not the same as delusions. Delusions are not a way of interpreting external stimuli but rather a defense mechanism. Expressing anger and hostility is typically associated with defense mechanisms like displacement or projection, not delusions.
3. 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.
4. Which reaction toward the physical symptom would the nurse observe in a client with conversion disorder?
- A. Anger
- B. Apathy
- C. Anxiety
- D. Agitation
Correct answer: B
Rationale: In conversion disorder, the nurse would observe apathy toward the physical symptom. The development of the symptom serves as an unconscious method of reducing anxiety. The symptom is accepted passively, known as 'la belle indiff�rence.' There is no anger observed as symptoms are passively accepted. Similarly, there is no direct anxiety related to the physical symptom, as the conflict is resolved through the symptom development. While many individuals might experience agitation and seek to identify the cause of physical symptoms, in conversion disorder, there is an unusual calmness or indifference towards the physical manifestation, indicating apathy rather than other emotional responses.
5. How is the secondary use of data from the 2000 census classification system utilized to address disparities in mental health care along racial-ethnic lines?
- A. To provide culturally relevant care to the required ethnic group
- B. To identify all racial and ethnic groups in the United States
- C. To identify why there are disparities in the United States
- D. To determine when and how the health care needs of the ethnic populations are being met
Correct answer: D
Rationale: The census classification system categorizes individuals based on racial and ethnic descriptions. Utilizing this data helps in identifying health disparities and assessing how the health care needs of ethnic populations are being addressed. Option A is incorrect because the primary focus is on analyzing healthcare needs met, not providing care. Option B is incorrect as the census does not encompass every single racial and ethnic group in the United States. Option C is incorrect as the census is not designed to investigate the reasons behind disparities, but rather to quantify and analyze them.
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