NCLEX-RN
Psychosocial Integrity NCLEX Questions
1. The best way for a healthcare provider and a healthcare facility to control the effects of poor and disruptive patient behavior is to _________________.
- A. prevent it
- B. restrain the patient
- C. medicate the patient
- D. isolate the patient
Correct answer: A
Rationale: The most effective approach to managing poor and disruptive patient behavior is by preventing it proactively. This involves implementing strategies, communication techniques, and environmental modifications that address the underlying causes of the behavior. Restraint, medication, and isolation should only be used as a last resort when the patient or others are at risk of harm. Restraint and isolation are primarily used to ensure safety, while medication, especially when used solely to control behavior, can have adverse effects and is considered a measure of last resort. Therefore, prevention is crucial in promoting a therapeutic environment and fostering positive patient outcomes.
2. Which response would the nurse make to a client who says, 'The voices say I'll be safe only if I stay in this room, wear these clothes, and avoid stepping on the cracks between the floor tiles'?
- A. Ask whether the voices are male or female and how many there are.
- B. Reassure the client by stating, 'I understand that these voices are real to you, but I want you to know that I don't hear them.'
- C. Offer false reassurance by saying, 'Don't worry"?I've locked the door to your room and won't let anyone in.'
- D. Encourage the client to leave the room and keep busy to distract from the voices.
Correct answer: B
Rationale: The response, 'I understand that these voices are real to you, but I want you to know that I don't hear them,' demonstrates empathy and validation of the client's experience while also gently bringing in the nurse's reality. This response acknowledges the client's feelings without reinforcing the hallucinations. Asking about the characteristics of the voices (Choice A) can inadvertently validate the hallucinations. Offering false reassurance (Choice B) may not be helpful as it does not address the client's distress. Encouraging the client to leave the room and keep busy (Choice D) is nontherapeutic as it disregards the client's experience and may increase anxiety.
3. Which communication technique is a part of therapeutic communication?
- A. Asking for explanations
- B. Showing sympathy to the client
- C. Asking personal questions of the client
- D. Providing relevant information to the client
Correct answer: D
Rationale: The correct answer is providing relevant information to the client. In therapeutic communication, it is essential to provide clients with all pertinent information to help them understand their health status and what to expect. This empowers clients and promotes trust in the nurse-client relationship. Asking for explanations, showing sympathy, and asking personal questions are examples of nontherapeutic communication techniques. Asking personal questions can intrude on the client's privacy and may not be relevant to their care. Showing sympathy, while well-intentioned, may come across as pity rather than true empathy. Asking for explanations can sometimes put clients on the defensive rather than fostering a collaborative dialogue.
4. The nurse is preparing to administer 10 mL of liquid potassium chloride through a feeding tube, followed by 10 mL of liquid acetaminophen. Which action should the nurse include in this procedure?
- A. Dilute each of the medications with sterile water prior to administration.
- B. Mix the medications in one syringe before opening the feeding tube.
- C. Administer water between the doses of the two liquid medications.
- D. Withdraw any fluid from the tube before instilling each medication.
Correct answer: C
Rationale: Water should be instilled into the feeding tube between administering the two medications to maintain the patency of the feeding tube and ensure that the total dose of medication enters the stomach and does not remain in the tube. These liquid medications do not need to be diluted when administered via a feeding tube. Mixing the medications in one syringe can lead to interactions or alterations in the medications' properties. Withdrawing any fluid from the tube before instilling each medication can cause inaccurate dosing and incomplete administration. Therefore, the correct action is to administer water between the doses of the two liquid medications to ensure proper delivery and avoid any complications.
5. A client had a first-trimester abortion and has been unable to function for 3 months. Which type of grief is the client experiencing?
- A. Complex bereavement
- B. Anticipatory
- C. Disenfranchised
- D. Complicated
Correct answer: C
Rationale: The client is experiencing disenfranchised grief. Disenfranchised grief refers to grief over a loss that is not socially recognized or acknowledged. In this case, grief after an abortion falls into this category. It can lead to prolonged emotional distress as the loss may not be openly acknowledged or supported by others. Complex bereavement is characterized by dysfunctional grieving that extends beyond 12 months. Anticipatory grief occurs when the loss is expected or predictable, allowing individuals to start the grieving process before the actual loss. Complicated grief is marked by an inability to progress through the grief stages, leading to intense feelings of depression, anger, and emptiness, often coupled with a preoccupation with the deceased.
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