NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. 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.
2. Which characteristic usually results in a behavior being viewed and accepted as normal?
- A. Fits within standards accepted by one's society
- B. Helps the person reduce the need for coping skills
- C. Allows the person to express feelings and thoughts
- D. Facilitates achievement of short-term and long-term goals
Correct answer: A
Rationale: Behaviors that align with the standards accepted by a society are generally viewed as normal. Societal norms and values play a significant role in defining what is considered normal behavior. Choices B, C, and D may be important aspects of an individual's functioning, but they do not solely determine whether a behavior is viewed as normal. Coping skills, expressions of feelings, and goal achievement can vary in their cultural context and societal acceptance, therefore they are not definitive indicators of normalcy.
3. Which term describes what an adolescent client is experiencing when she says to the nurse who has been caring for her, 'You're just like my mother; I hate you'?
- A. Insight
- B. Universality
- C. Transference
- D. Identification
Correct answer: C
Rationale: Transference occurs when a client unconsciously assigns feelings and attitudes originally associated with another important person in the client's life. In this scenario, the adolescent client is projecting emotions connected to her mother onto the nurse. This client's statement does not demonstrate insight but rather reflects the mechanism of transference. Universality refers to the sense that one is not alone in any situation, which is not evident in the client's statement. Identification is a defense mechanism where an individual takes on characteristics of someone considered admirable, which is not the case in this situation.
4. The mother of an infant in the neonatal intensive care unit expresses concern about her infant. Which nursing intervention best facilitates mother-infant bonding?
- A. Asking the mother to change her baby's diaper
- B. Assuring the mother that her baby is receiving excellent care
- C. Encouraging the mother to touch her baby whenever possible
- D. Keeping the mother informed about the care the nursing staff is providing her baby
Correct answer: C
Rationale: Encouraging the mother to touch her baby whenever possible is the best intervention to promote mother-infant bonding, especially when the infant is too ill to be held. Physical touch is a powerful way to establish a connection. Mother-infant bonding is a gradual process and encouraging touch can help initiate this bond. Asking the mother to change her baby's diaper is not the most appropriate action to promote bonding in this scenario. Assuring the mother about the care her baby is receiving is important but does not directly enhance bonding. Keeping the mother informed about the care her baby is receiving is crucial, but it alone does not actively foster bonding between the mother and infant.
5. Which parental statement would the nurse recognize as the appropriate application of time-out when disciplining a 4-year-old?
- A. I send my child to their bedroom for misbehaving.
- B. We limit time-out to 4 minutes per incident.
- C. Putting my child in a dark closet for time-out is very effective.
- D. I explain the reason for the time-out before and after disciplining my child.
Correct answer: D
Rationale: The correct answer is to explain the reason for the time-out before and after disciplining the child. This approach reinforces the child's association of the time-out with the undesirable behavior, helping the child learn to control those behaviors. Sending a child to their bedroom may lead to negative associations with bedtime or be ineffective if the child enjoys spending time in their bedroom. Time-out should ideally be limited to 1 minute per year of age, so a time-out for a 4-year-old should be limited to 4 minutes. Placing a child in a dark closet can create fear and damage the child's trust in their parents as a source of safety, making it an inappropriate and harmful approach. Even if this method seems effective in the short term, the potential long-term consequences outweigh any immediate benefits.
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