NCLEX-RN
Psychosocial Integrity NCLEX PN Questions
1. While communicating with a client, the nurse determines that the client has realized the harmful effects of alcohol consumption and plans to stop drinking within 6 months. Which stage of the transtheoretical model of change would the nurse correlate the client's behavior with?
- A. Action
- B. Preparation
- C. Maintenance
- D. Contemplation
Correct answer: D
Rationale: The transtheoretical model of change defines changing patterns in individuals across five stages based on their readiness to change. The stages are precontemplation, contemplation, preparation, action, and maintenance. In the contemplation stage, the client acknowledges the benefits of change and considers making the change within the next 6 months. This aligns with the client's realization of the harmful effects of alcohol consumption and intent to stop drinking within 6 months. The action stage involves actively making changes, the preparation stage includes goal-setting with an intention to change within 60 days, and the maintenance stage focuses on sustaining changed behavior for at least 6 months and taking preventive measures to avoid relapse. Therefore, in this scenario, the client's behavior aligns with the contemplation stage of the transtheoretical model of change.
2. Which intervention would the nurse use to provide emotional support for a resident in a nursing home who recently immigrated from another country?
- A. Offer choices consistent with the resident's heritage.
- B. Assist the resident in adjusting to the nursing home culture.
- C. Ensure that the resident is treated respectfully like the other residents.
- D. Correct any misconceptions the resident may have about appropriate health practices.
Correct answer: A
Rationale: When providing emotional support to a resident in a nursing home who recently immigrated from another country, it is essential for the nurse to offer choices that align with the resident's heritage. This approach respects the resident's cultural beliefs and practices, promoting a sense of familiarity and comfort. Assisting the resident in adjusting to the nursing home culture is important but may not address the specific emotional support needed. While ensuring that the resident is treated respectfully is crucial, offering choices consistent with the resident's heritage goes a step further by acknowledging and valuing the resident's cultural background. Correcting any misconceptions about health practices is essential, but in this context, emotional support through cultural sensitivity takes precedence.
3. Which reaction toward the physical symptom would the nurse observe in a client with conversion disorder?
- A. Anger
- B. Apathy
- C. Anxiety
- D. Agitation
Correct answer: B
Rationale: In conversion disorder, the nurse would observe apathy toward the physical symptom. The development of the symptom serves as an unconscious method of reducing anxiety. The symptom is accepted passively, known as 'la belle indiff�rence.' There is no anger observed as symptoms are passively accepted. Similarly, there is no direct anxiety related to the physical symptom, as the conflict is resolved through the symptom development. While many individuals might experience agitation and seek to identify the cause of physical symptoms, in conversion disorder, there is an unusual calmness or indifference towards the physical manifestation, indicating apathy rather than other emotional responses.
4. A client recently had an abdominoperineal resection and colostomy. While the nurse changes the dressing, the client states, 'You think that it looks repulsive.' The nurse identifies that the client is using which defense mechanism?
- A. Projection
- B. Sublimation
- C. Compensation
- D. Intellectualization
Correct answer: A
Rationale: The correct answer is Projection. Projection is the defense mechanism where unacceptable feelings and emotions are attributed to others. In this scenario, the client is projecting their own feelings of repulsion onto the nurse. Sublimation involves substituting socially acceptable feelings to replace threatening ones. Compensation refers to overachievement in a different area to cover up a weakness. Intellectualization is the use of mental reasoning to avoid facing emotional aspects of a situation.
5. 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.
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