NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. What initial treatment would the nurse expect for a preschool-aged child experiencing severe fear of the dark?
- A. Prescription medication
- B. Mental health counseling
- C. Cognitive behavioral therapy
- D. Repetition of brave statements
Correct answer: D
Rationale: Repetition of brave statements is an effective initial treatment for preschool-aged children with severe fear of the dark. This technique involves encouraging the child to repeat positive and reassuring statements to themselves to build confidence and reduce fear. Prescription medication is not typically the first-line approach for this type of fear in children due to potential side effects and safety concerns. Mental health counseling and cognitive behavioral therapy may be considered if the fear persists or is severe, but they are usually not the initial treatments for preschool-aged children with fear of the dark.
2. 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.'
3. Which of the following is a nursing intervention for a client who is experiencing an acute panic attack?
- A. Encourage the client to sit down in a quiet environment
- B. Allow the client to direct the situation
- C. Try to focus the client on one aspect of care, such as regulating breathing patterns
- D. Speak in a commanding tone of voice to get the client's attention
Correct answer: C
Rationale: When assisting a client with an acute panic attack, the primary goal is to help reduce their anxiety levels. Encouraging the client to focus on one controllable aspect, like regulating breathing patterns, can aid in calming them down. This intervention helps the client to regain control over their breathing, which can alleviate some of the symptoms associated with panic attacks. Options A and B are incorrect because allowing the client to direct the situation or sit down in a quiet environment may not be beneficial during an acute panic attack. Option D is inappropriate as speaking in a commanding tone can further escalate the client's anxiety rather than helping to calm them down.
4. What psychodynamic process is suggested by a client calling the emergency department during a suicide attempt?
- A. A cry for help
- B. A need for attention
- C. Ambivalence about dying
- D. An inability to stick to a decision
Correct answer: C
Rationale: The correct answer is 'Ambivalence about dying.' When a client calls the emergency department during a suicide attempt, it suggests conflicting feelings about living and dying. This act can indicate an unconscious desire to be stopped from dying, showing ambivalence between the wish to die and the wish to live. It is not primarily a cry for attention or a need to punish others. The client's intention of suicide alongside seeking help demonstrates the struggle between life and death, making ambivalence the key psychodynamic process at play.
5. Which clinical findings indicate positive signs and symptoms of schizophrenia?
- A. Withdrawal, poverty of speech, inattentiveness
- B. Flat affect, decreased spontaneity, asocial behavior
- C. Hypomania, labile mood swings, episodes of euphoria
- D. Bizarre behavior, auditory hallucinations, loose associations
Correct answer: D
Rationale: The correct answer is bizarre behavior, auditory hallucinations, and loose associations. These are positive symptoms of schizophrenia, reflecting a distortion or excess of normal function. Withdrawal, poverty of speech, inattentiveness, flat affect, decreased spontaneity, and asocial behavior are negative symptoms linked to schizophrenia, indicating a diminution or absence of normal function. Hypomania, labile mood swings, and episodes of euphoria are more characteristic of bipolar disorder, rather than schizophrenia.
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