NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. What is the primary purpose served when an individual takes action to reduce anxiety?
- A. Reduction of tension
- B. Denial of the situation
- C. Avoidance of physical discomfort
- D. Resolution in decision-making
Correct answer: A
Rationale: The primary purpose of taking action to reduce anxiety is to alleviate emotional tension and prevent the exacerbation of anxiety symptoms. By reducing tension, anxiety levels decrease, leading to a sense of comfort, safety, and security. Denial of the situation is not the goal when addressing anxiety; rather, acknowledging and managing it is crucial. While physical discomfort may accompany anxiety, the focus is on alleviating the emotional aspect to mitigate physical manifestations. Although mild anxiety can sometimes improve decision-making skills, higher levels of anxiety typically impede cognitive functions, making resolution in decision-making less likely.
2. Which approach would the healthcare provider use when managing the care of a client diagnosed with generalized anxiety disorder (GAD)?
- A. Creating an anxiety-free environment for the client
- B. Assisting the client with the development of healthy, adaptive coping mechanisms
- C. Avoiding triggers that produce anxiety in the client
- D. Providing reinforcement that the client's anxiety issues can be eliminated
Correct answer: B
Rationale: The healthcare provider would assist the client with the development of healthy, adaptive coping mechanisms. GAD is characterized by the maladaptive use of worrying as a coping mechanism. The ultimate goal is for the healthcare provider to help the client replace the ineffective worrying with effective, healthy coping mechanisms. Creating an anxiety-free environment is not feasible or recommended; the goal is to help the client learn to deal with anxiety in a healthy manner. While identifying triggers is important, avoiding all triggers that produce anxiety is often impractical. Providing reinforcement that anxiety issues can be eliminated is not appropriate as anxiety is a normal human experience that needs to be managed effectively rather than eliminated completely.
3. By rolling contaminated gloves inside-out, the nurse is affecting which step in the chain of infection?
- A. Mode of transmission
- B. Portal of entry
- C. Reservoir
- D. Portal of exit
Correct answer: A
Rationale: When the nurse rolls contaminated gloves inside-out, they are manipulating the mode of transmission in the chain of infection. The gloves, which are contaminated, act as a vehicle for transferring pathogens from the reservoir's portal of exit to a potential portal of entry. Choices B, C, and D are incorrect because the action of rolling contaminated gloves does not directly relate to the portal of entry, reservoir, or portal of exit in the chain of infection.
4. Which response would the nurse make at lunchtime to a client who is sitting alone with the head slightly tilted as if listening to something?
- A. "I know you're busy, but it's lunchtime."
- B. "Are the voices bothering you again?"
- C. "Get going; you don't want to miss lunchtime."
- D. "It's lunchtime; I'll walk with you to the dining room."
Correct answer: D
Rationale: The statement, "It's lunchtime; I'll walk with you to the dining room," demonstrates setting limits and providing support. Hallucinations can be frightening, and the nurse's presence offers support and reality without focusing on the hallucination directly. Choice A, "I know you're busy, but it's lunchtime," does not recognize the client's need for support and direction. Choice B, "Are the voices bothering you again?", makes a judgment without sufficient evidence and overly focuses on the hallucination, failing to address the client's need for support and direction. Choice C, "Get going; you don't want to miss lunchtime," does not acknowledge the client's need for reality, support, and direction, and may come across as threatening.
5. A female adolescent has anorexia nervosa and is malnourished and severely underweight. Which statement indicates that she is experiencing secondary gains from her behavior?
- A. "I'm huge; I'm as big as a house."
- B. "I get straight A's in all my subjects."
- C. "My mother keeps trying to get me to eat."
- D. "My hair is beginning to fall out in clumps."
Correct answer: C
Rationale: The statement "My mother keeps trying to get me to eat" indicates that the adolescent is experiencing secondary gains from her behavior. This is because the behavior has garnered attention from her mother, providing a sense of power and control, which are considered secondary gains. The statement "I'm huge; I'm as big as a house" reflects a disturbed body perception and is not related to secondary gains. Getting straight A's in all subjects is an achievement but not a secondary gain related to anorexia nervosa. The hair falling out in clumps is a physical consequence of starvation, not a secondary gain.
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