NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which of these is a one-on-one communication between the nurse and another person?
- A. Small-group communication
- B. Intrapersonal communication
- C. Interpersonal communication
- D. Transpersonal communication
Correct answer: C
Rationale: Interpersonal communication is a one-on-one interaction between a nurse and another person that often occurs face-to-face. It involves direct communication between two individuals. Small-group communication involves interaction among a small number of people, not just one-on-one. Intrapersonal communication is internal communication that occurs within an individual's mind. Transpersonal communication involves interactions within a person's spiritual domain, which is beyond individual one-on-one communication.
2. Which of the following outcomes is most appropriate during the crisis stage of caring for a victim of domestic violence?
- A. The client will verbalize community resources from which to seek shelter after discharge.
- B. The client will write a plan to keep herself and her children safe.
- C. The client will contact an attorney for help with pressing charges.
- D. The client will be safe and receive treatment for injuries.
Correct answer: D
Rationale: During the crisis stage of caring for a victim of domestic violence, the immediate priority is ensuring the client's safety and providing treatment for any injuries sustained. This focuses on addressing the urgent physical and emotional needs of the victim. While options like verbalizing community resources or creating safety plans are important for long-term support, they are not the primary concerns during the crisis phase. Contacting an attorney for legal assistance, though vital in the future, is not the immediate priority during the crisis stage when the client's safety and health are at the forefront.
3. What step should be taken when administering ear drops to an adult client?
- A. Place the client in a side-lying position.
- B. Hold the dropper 1 cm above the ear canal.
- C. Place a cotton ball into the outermost canal.
- D. Pull the auricle down and back.
Correct answer: A
Rationale: The correct step when administering ear drops to an adult client is to place the client in a side-lying position (A). This position allows for easier administration of the drops and helps prevent spillage. The dropper should be held approximately 1 cm (� inch) above the ear canal (B) to ensure accurate delivery of the medication. Placing a cotton ball into the outermost canal (C) is unnecessary and may interfere with the absorption of the ear drops. Pulling the auricle down and back (D) is a technique used for children younger than 3 years old to straighten the ear canal, but it is not necessary for adults and may cause discomfort.
4. A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of "suppression"?
- A. "I don't remember anything about what happened to me."
- B. "I'd rather not talk about it right now."
- C. "It's the other guy's fault! He was going too fast."
- D. "My mother is heartbroken about this."
Correct answer: A
Rationale: The correct answer is "I don't remember anything about what happened to me." This statement indicates the use of suppression, which is the willful act of putting an unacceptable thought or feeling out of one's mind. In this case, the client is deliberately excluding memories of the traumatic event to protect their self-esteem. The other choices do not reflect suppression: Choice B shows avoidance or deflection, Choice C demonstrates blame shifting, and Choice D indicates empathy towards another individual.
5. A college athlete sustained a complete transection of the spinal cord while practicing on a trampoline. The health care provider explained that return of function to the lower extremities is not likely. Two weeks later, the client verbalizes the need to practice for an upcoming tournament. Which conclusion would the nurse make about the client's statement?
- A. Exhibiting denial
- B. Verbalizing a fantasy
- C. No longer able to adapt
- D. Motivated to recover mobility
Correct answer: A
Rationale: The correct answer is 'Exhibiting denial.' Denial is a common defense mechanism when facing a serious health issue. The individual rejects the existence of the problem due to the overwhelming anxiety and emotional distress it causes. In this case, the athlete's desire to practice for an upcoming tournament despite being informed about the unlikely return of lower extremity function indicates denial of the severity of their condition. Choice B, 'Verbalizing a fantasy,' is incorrect as a fantasy involves creating imagined events to fulfill unconscious wishes, which is not evident here. Choice C, 'No longer able to adapt,' is incorrect because the client is actually demonstrating a maladaptive coping mechanism by denying the reality of their situation. Choice D, 'Motivated to recover mobility,' is incorrect as the client's goal of practicing for a tournament does not align with the realistic expectation of recovering mobility after a complete spinal cord transection.
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