NCLEX-RN
NCLEX Psychosocial Questions
1. While planning care for a 2-year-old hospitalized child, which situation would the nurse most likely expect to affect the behavior?
- A. Strange bed and surroundings.
- B. Separation from parents.
- C. Presence of other toddlers.
- D. Unfamiliar toys and games.
Correct answer: B
Rationale: The correct answer is 'Separation from parents.' Separation anxiety is most evident from 6 months to 30 months of age. It is the greatest stress imposed on a toddler by hospitalization. If separation is avoided, young children have a tremendous capacity to withstand other stress. Choices A, C, and D are incorrect because while strange bed and surroundings, presence of other toddlers, and unfamiliar toys and games may contribute to some level of stress or discomfort, the separation from parents is the primary factor affecting the behavior of a 2-year-old hospitalized child.
2. Which behavior indicates that the client has learned the most effective method to cope with anger?
- A. Goes for a long jog
- B. Talks about the anger
- C. Goes outside and screams
- D. Focuses on cause of anger
Correct answer: B
Rationale: The correct answer is 'Talks about the anger.' This response indicates that the client has learned a positive coping method, as discussing angry feelings is a healthier way of dealing with anger. Talking about anger allows for expression and communication, leading to a better understanding of the emotions involved. Going for a long jog or screaming outside may provide temporary relief, but they do not address the root cause or help in processing the emotions effectively. Focusing solely on the cause of anger without expressing feelings may lead to increased frustration and escalation of anger, rather than promoting constructive coping mechanisms.
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. The family of a child with cerebral palsy (CP) is at risk for difficult parenting issues. Which basis would the nurse conclude as the probable cause for this difficulty?
- A. Lack of social support
- B. Unrealistic expectations
- C. Loss of the expected healthy child
- D. Having a child with cognitive impairment
Correct answer: C
Rationale: The correct answer is 'Loss of the expected healthy child.' Parents of a child with cerebral palsy often grieve the loss of the healthy child they expected, mourning what could have been and what may never be. While lack of social support can contribute to parenting difficulties, it is not the primary basis in this case. Unrealistic expectations may play a role for some parents, but not all. Additionally, it is important to note that not all children with cerebral palsy experience cognitive impairment; around 30% to 50% of children with cerebral palsy have cognitive challenges.
5. 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.
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