NCLEX-PN
Psychosocial Integrity Nclex PN Questions Questions
Extract:
Question 1 of 5
Ashley and her boyfriend Chris, both 19 years old, are transported to the Emergency Department after being involved in a motorcycle accident. Chris is badly hurt, but Ashley has no apparent injuries, though she appears confused and has trouble focusing on what is going on around her. She complains of dizziness and nausea. Her pulse is rapid, and she is hyperventilating. The nurse should assess Ashley's level of anxiety as:
Correct Answer: C
Rationale: Explanation: Ashley is displaying symptoms of severe anxiety, including confusion, trouble focusing, dizziness, nausea, rapid pulse, and hyperventilation. These somatic symptoms, along with changes in vital signs, indicate severe anxiety. In severe anxiety, individuals are unable to solve problems and have a poor grasp of their environment. On the other hand, mild anxiety may lead to mild discomfort or even enhanced performance, while moderate anxiety results in difficulty grasping information and minor changes in vital signs. Panic, the most severe level of anxiety, involves markedly disturbed behavior and a potential loss of touch with reality.
Therefore, based on Ashley's symptoms, her anxiety level should be assessed as severe.
Question 2 of 5
During the work phase of the nurse-client relationship, the client says to her primary nurse, "You think that I could walk if I wanted to, don't you?"? What is the best response by the nurse?
Correct Answer: D
Rationale: This response answers the question honestly and nonjudgmentally and helps to preserve the client's self-esteem. The nurse acknowledges the client's current inability to walk without attributing it to the client's desire.
Choice A provides a positive but unrealistic statement that may diminish the client's self-esteem by implying a lack of effort.
Choice B deflects the client's question and does not address the underlying concern.
Choice C may increase the client's anxiety by suggesting unresolved psychological conflicts related to walking.
Question 3 of 5
A successful resolution of the nursing diagnosis Negative Self-Concept (related to unrealistic self-expectations) is when the client can:
Correct Answer: A
Rationale: The correct answer is to 'report a positive self-concept.' The problem statement is Negative Self-Concept, so the goal is for the client to achieve a positive self-concept. This involves helping the client recognize their worth and strengths.
Choices B, C, and D do not directly address the resolution of Negative Self-Concept. Identifying negative thoughts (
B) is a step towards improvement but does not represent a successful resolution. Recognizing positive thoughts (
C) is positive but not the primary goal in addressing Negative Self-Concept. 'Give one positive cue with each negative cue' (
D) is not as comprehensive as achieving an overall positive self-concept.
Question 4 of 5
Tricyclics (Antidepressants) can sometimes have which of the following adverse effects on patients diagnosed with depression?
Correct Answer: B
Rationale: The correct answer is 'Fainting.' Tricyclic antidepressants can cause fainting and hypotension as adverse effects. Shortness of breath (
Choice
A) is not a common side effect of tricyclics. Large intestine ulcers (
Choice
C) are not typically associated with tricyclic antidepressants. Distal muscular weakness (
Choice
D) is not a common adverse effect of tricyclics but is commonly associated with other medications.
Question 5 of 5
A primary belief of psychiatric mental health nursing is:
Correct Answer: B
Rationale: The correct answer is that every person is worthy of dignity and respect. This is a fundamental principle in psychiatric mental health nursing, emphasizing the importance of treating individuals with dignity and respect regardless of their condition. This belief forms the basis of establishing a therapeutic nurse-client relationship.
Choice A is a positive belief, but the primary focus in psychiatric mental health nursing is on respecting the worth and dignity of each individual.
Choice C is related to understanding individual human needs but does not encompass the core value of dignity and respect.
Choice D is incorrect as psychiatric nursing emphasizes the importance of interpreting and understanding all behaviors as meaningful expressions of the client's experience.