NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. An older woman has lived alone since the death of her husband 10 years ago, and she has a long list of vague complaints. Which assessment is the priority for the home health nurse to perform?
- A. Assess for feelings of loneliness and isolation.
- B. Determine if the client has unresolved grief.
- C. Determine if there are safety issues.
- D. Ask about the availability of support systems.
Correct answer: C
Rationale: The priority assessment for the home health nurse in this scenario is to determine if there are safety issues. The client is an older woman living alone with a long list of vague complaints, indicating several risk factors. Ensuring her safety should be the primary concern. While assessing for feelings of loneliness, isolation, or grief is important, ensuring the client's safety takes precedence due to her vulnerable situation. Although assessing the availability of support systems is essential in a home health assessment, safety issues must be addressed first given the client's profile.
2. Which therapeutic technique can the nurse use when an anxious client exhibits pressured and rambling speech?
- A. Touch
- B. Silence
- C. Focusing
- D. Summarizing
Correct answer: C
Rationale: Focusing is the appropriate therapeutic technique to use when an anxious client exhibits pressured and rambling speech. By focusing on one specific aspect, the intended meaning is easier to understand and helps the client stay on track. Touch is not recommended in this scenario as it can invade the client's personal space and potentially increase anxiety. Silence may allow the client to continue rambling without addressing the underlying concerns. Summarizing requires the identification and exploration of the client's concerns, which may be challenging when the speech is pressured and disorganized.
3. Which behavior indicates that the client has learned the most effective method to cope with anger?
- A. Goes for a long jog
- B. Talks about the anger
- C. Goes outside and screams
- D. Focuses on cause of anger
Correct answer: B
Rationale: The correct answer is 'Talks about the anger.' This response indicates that the client has learned a positive coping method, as discussing angry feelings is a healthier way of dealing with anger. Talking about anger allows for expression and communication, leading to a better understanding of the emotions involved. Going for a long jog or screaming outside may provide temporary relief, but they do not address the root cause or help in processing the emotions effectively. Focusing solely on the cause of anger without expressing feelings may lead to increased frustration and escalation of anger, rather than promoting constructive coping mechanisms.
4. Which statement best describes the pathophysiology of dementia of the Alzheimer type?
- A. There is a genetic predisposition and dysregulation of neurotransmitters.
- B. The dementia is transient and secondary to a physical imbalance or disorder.
- C. Hypoxia and decreased perfusion of select areas of the brain cause tissue damage.
- D. The presence of amyloid plaques is associated with brain tissue destruction.
Correct answer: D
Rationale: In Alzheimer's disease, the accumulation of amyloid plaques in the brain is a hallmark feature. These plaques are associated with the destruction of brain tissue, contributing to the cognitive decline seen in dementia. Genetic predisposition and dysregulation of neurotransmitters are factors linked to the development of Alzheimer's disease, but the primary pathology lies in the amyloid plaques. Transient dementia is not characteristic of Alzheimer's disease, which is a progressive neurodegenerative disorder. Hypoxia and decreased perfusion are more typical of vascular dementia, where blood flow to the brain is compromised.
5. Which of the following is a true statement about palliative care?
- A. The goal of palliative care is to provide end-of-life care for a client as they transition toward death.
- B. Palliative care provides comfort and support for those who may have a terminal illness.
- C. Palliative care provides resources for funeral arrangements after death.
- D. Palliative care is a support network for family and friends after the death of a loved one.
Correct answer: B
Rationale: Palliative care is a type of care that focuses on providing support and comfort to individuals who may have a terminal illness or severe symptoms. It aims to improve the quality of life for both the individual receiving care and their family. While it can be provided in various settings, including hospitals, homes, or specialized facilities, the primary focus is on symptom management and addressing the physical, emotional, and spiritual needs of the individual. Choice A is incorrect because palliative care is not solely limited to end-of-life care but also includes managing symptoms and improving quality of life. Choice C is incorrect as palliative care is focused on providing care and support during the individual's life, not on funeral arrangements after death. Choice D is incorrect as palliative care is primarily directed towards the individual receiving care, although it may also provide support to their family and friends during the care process.
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