NCLEX-RN
NCLEX Patient Needs Psychosocial Integrity Therapeutic Communications Questions
Extract:
Question 1 of 5
The family of a client diagnosed with a myocardial infarction complicated by cardiogenic shock is visibly anxious and upset about the client's condition. Which should the nurse plan to implement to provide support to the family?
Correct Answer: D
Rationale: The use of flexible visiting hours meets the needs of both the client and family for reducing the anxiety levels of both. Offering the family beverages does not provide support. Insisting that the family go home is nontherapeutic. Although the chaplain may provide support, it is unrealistic for the chaplain to stay until the client stabilizes.
Question 2 of 5
An English-speaking Hispanic client has a newly applied long leg cast to stabilize a right proximal fractured tibia. During rounds at night, the nurse finds the client restless, withdrawn, and unusually quiet. Which nursing statement would be most appropriate?
Correct Answer: B
Rationale: Option 2 is open-ended and makes no assumptions about the client's psychological or emotional state. Option 1 is incorrect because males in traditional standard Hispanic cultures practice 'machismo' in which stoicism is valued, so this client may deny any pain when asked. False reassurance is never therapeutic, which makes option 3 incorrect. Option 4 is incorrect because an assessment is necessary before administering medication for pain.
Question 3 of 5
The nurse is caring for a client diagnosed with left-sided Bell's palsy. Which statement by the client shows a need for further teaching by the nurse?
Correct Answer: C
Rationale: Bell's palsy is an inflammatory condition that involves the facial nerve (cranial nerve VII). Although it results in facial paralysis, it is not the same as a stroke. Many clients fear that they have had a stroke when the symptoms of Bell's palsy appear, and they commonly believe that the paralysis is permanent. Symptoms resolve, although it may take several weeks. The remaining options are expected assessment findings of the client with Bell's palsy.
Question 4 of 5
The nurse is assessing a client who was just admitted to the psychiatric unit. The client says, 'You won't have to worry about me much longer.' Which meaning should the nurse interpret from this statement?
Correct Answer: A
Rationale: A client who is at risk for suicide who says, 'You won't have to worry about me much longer,' is making an expression of a suicidal intent. Although depression, self-mutilation, and hopelessness may relate to violence to oneself, the statement that he or she will not be around is a direct comment about the act of suicide.
Question 5 of 5
A primigravida client who came to the clinic has been diagnosed with a urinary tract infection. She repeatedly verbalizes concern regarding the safety of the fetus. Which should the nurse address first?
Correct Answer: A
Rationale: The primary concern of this client is the safety of her fetus rather than herself. The priority for the nurse to address at this time is the issues regarding safety. The remaining options lack this priority.