NCLEX-RN
Psychosocial Integrity NCLEX RN Questions Questions
Extract:
Question 1 of 5
The nurse on the psychiatric unit notices that a client diagnosed with depression does not eat meals. Which response by the nurse is appropriate?
Correct Answer: B
Rationale: Asking the client to identify favorite foods engages them in their care and may increase appetite by incorporating preferences, addressing the underlying issue of poor intake. Other options may not address motivation or may impose goals without client input.
Question 2 of 5
The nurse plans care for a client diagnosed with anorexia nervosa. Which goal will the nurse make a priority for this client?
Correct Answer: A
Rationale: Gradual weight gain (0.25 lb/week) is the priority goal for anorexia, addressing malnutrition and physical health risks. Electrolyte balance and meal consumption are important but secondary, and identifying normal weight is a long-term cognitive goal.
Question 3 of 5
The home health nurse visits a client with cancer undergoing anti-cancer treatment. The nurse asks how the client is coping, and the client cries and with an angry voice says, 'Nobody understands. I am hanging on, trying to take one day at a time, but it is all I can do to get up in the morning.' How does the nurse best respond?
Correct Answer: A
Rationale: Asking about desired support empowers the client to express needs, addressing their feelings of being misunderstood. Empathizing without guidance, focusing on family, or suggesting a support group without client input is less client-centered.
Question 4 of 5
A female client with the diagnosis of mania emerges from her room topless while making sexual remarks and lewd gestures toward the staff and her peers. Which intervention should the nurse implement first?
Correct Answer: A
Rationale: A person who is experiencing mania lacks insight and judgment, has poor impulse control, and is highly excitable. The nurse must take control without creating increased stress or anxiety for the client. Insisting that the client go to her room may cause the nurse to be met with a great deal of resistance. Confronting the client and offering her a consequence of time out may be meaningless to her. Asking other clients to ignore her is inappropriate. A quiet but firm approach while distracting the client (walking her to her room and helping her to get dressed) achieves the goal of having the client dressed appropriately and preserving her psychosocial integrity.
Question 5 of 5
The nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. The nurse should recognize that which teaching plan component is most important initially?
Correct Answer: B
Rationale: Before educating about a disease process, it is important that the client understands the components of the disease process. After this teaching, the actual components of diet, blood glucose testing, and insulin injections can be taught.