Psychosocial Fundamental NCLEX Questions
On entering the room of a client who has undergone a dilatation and curettage (D&C;) for a spontaneous abortion, the nurse finds the client crying. Which comment by the nurse would be most appropriate? a) "I am truly sorry you lost your baby." b) "It is important that you do not try to get pregnant too soon." c) "Commonly spontaneous abortion means a defective embryo." d) "Are you having a great deal of uterine pain?"
"I am truly sorry you lost your baby."
A 19-year-old client has undergone an examination and had evidence collected after being raped. Her father is overheard yelling at his daughter, "You are going to tell me who did this to you. What is his name?" Which is the nurse's best response? a) "Please come with me, sir. I need some important information." b) "If you do not stop yelling, I will have to call Security." c) "Please be quiet. You are not helping your daughter this way." d) "Stop yelling. You are being inappropriate."
"Please come with me, sir. I need some important information."
A client with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome confides that he is homosexual and his employer does not know his HIV status. Which response by the nurse is best? a) "Would you like me to help you tell them?" b) "The information you confide in me is confidential." c) "I must share this information with your employer." d) "I must share this information with your family."
"The information you confide in me is confidential."
A client who is in the emergency department after a car accident is displaying anxiety, lack of attention, dizziness, nausea, tachycardia, and hyperventilation. Which statement would indicate that the nurse is reacting to the client's relief behavior rather than the client's needs? a) "There is nothing physically wrong with you. You need to stop breathing so rapidly." b) "Accidents can result in all kinds of feelings. It must have been scary." c) "I'll stay with you in case you would like to share your feelings with me." d) "It must have been a frightening experience to be in an accident."
"There is nothing physically wrong with you. You need to stop breathing so rapidly.
Which client statement indicates that the client has coped effectively with a relationship problem? a) "I can understand how my wife and I see things differently." b) "My wife and I are talking about our likes and dislikes in activities." c) "We are really listening to each other about our different view on issues." d) "My wife will be happy to know that I can spend less time at work now."
"We are really listening to each other about our different view on issues."
A worried mother confides in the nurse that she wants to change primaryhealth care providers (HCP's) because her infant is not getting better. What is the nurse's best response? a) "This primary care provider has been on our staff for 20 years." b) "You always have an option to change. Tell me about your concerns." c) "I know you are worried, but the primary care provider has an excellent reputation." d) "YoDuring hospitalization for a suicide attempt, a
"You always have an option to change. Tell me about your concerns."
A client, age 40, is admitted for treatment of a breast tumor. She asks the nurse, "Do you think I have cancer?" Which response by the nurse is most therapeutic? a) "We won't know for sure until you undergo some tests." b) "Most women your age have some kind of breast problem." c) "Your physician can tell you more about that." d) "You sound concerned about what the physicians will tell you."
"You sound concerned about what the physicians will tell you."
A client admitted for treatment of a colon tumor, asks, "Do I have cancer?" Which response by the nurse would be best? a) "Your physician can discuss this in more detail." b) "You'll have to have some tests before the physician can rule out cancer." c) "Most people your age develop some type of colon problem." d) "You sound concerned about what's happening."
"You sound concerned about what's happening."
A nurse is preparing a client for chemotherapy to treat colon cancer. The client says, "I don't know about this treatment. After everything is said and done, it may not do a bit of good. This thing may get me anyway." Which response by the nurse is most therapeutic? a) "Everyone who has cancer worries, but you have every reason to be hopeful." b) "Colon cancer can now be cured in many cases. Let's hope you'll be one of the lucky ones." c) "You're wondering whether you've made the right decision about your treatment." d) "Many people beat cancer. You need to keep a positive attitude."
"You're wondering whether you've made the right decision about your treatment."
The parent of an 18-year-old with chronic renal disease states, "My son has so many problems. I'm really worried that he will not get the right care if he gets sick at college." The nurse should tell the parent: a) "Make sure your son always carries his nephrologist's phone number." b) "I can have his records sent to the school's health center." c) "Your son can make an e-health history to facilitate his care if he gets sick away from home." d) "Your son is going to need to learn to manage his own disease."
"Your son can make an e-health history to facilitate his care if he gets sick away from home."
A client recently diagnosed with cancer informs the nurse that she values and finds comfort in her faith. The nurse is aware that faith is best defined as which of the following? a) An organized belief system about a high power. b) A belief in something for which there is no proof or material evidence. c) A positive outlook even in the bleakest moments. d) Practices associated with all aspects of a person's life.
A belief in something for which there is no proof or material evidence.
Which description best matches the role of a parish nurse? a) A spiritual leader, such as a minister, who is also a registered nurse. b) A nurse who works to reintegrate the healing tradition into the life of a faith community. c) A nurse who provides home health services similar to a visiting nurse. d) A trained layperson who provides for the spiritual needs of a congregation or parish.
A nurse who works to reintegrate the healing tradition into the life of a faith community.
A young man makes an appointment to see the psychiatric nurse at the Employee Assistance Program of a large corporation beacuse his boss is sending him provocative e-mails and making seductive remarks on his voice mail at home. The nurse informs him about corporate workplace violence guidelines, and he agrees to work with corporate security on the issue. What should the nurse do next? a) Suggest the client contact human resources to request a job transfer. b) Ask the client about his reactions to this situation. c) Refer the client to his boss's supervisor to file a report. d) Report the incident to the client's coworkers who are at risk for similar harassment.
Ask the client about his reactions to this situation.
A client states, "If my heart stops beating, I do not want to be resuscitated." Which action should the nurse take? a) Ask the client if he discussed this with the healthcare provider. b) Advise the client that a notarized advanced directive must be provided. c) Advise the client to designate a person as a medical power of attorney. d) Place a "Do Not Resuscitate" sign over the client's bed.
Ask the client if he discussed this with the healthcare provider.
The nurse is aware that clients in the initial stages of a terminal diagnosis may present with which of the following behaviors? a) Asking for other medical opinions b) Criticizing medical care received c) Becoming isolated and refusing visitors d) Crying uncontrollably over the diagnosis
Asking for other medical opinions
A 12-year-old African-American boy has experienced significant blood loss and may require a blood transfusion. The boy's mother, father, and sisters are currently present at his bedside in the emergency department. How should the nurse direct questions and teaching about his condition and treatment? a) Direct questions to the family collectively to avoid presuming who is dominant. b) Address the mother, as African-American families are commonly matriarchal. c) Assess who is the dominant member of the family and then address that person. d) Ask the boy's father what should be done, but make eye contact with everyone in the room.
Assess who is the dominant member of the family and then address that person.
A mother reports she cannot afford the antibiotic azithromycin, which was prescribed by the health care provider (HCP) for her toddler's otitis media. What is the nurse's best response? a) Confer with the HCP about whether a less expensive drug could be prescribed. b) Ask the mother if she has considered using any medical assistance programs in her community. c) Consult with the social worker. d) Instruct the mother on the importance of the medication.
Confer with the HCP about whether a less expensive drug could be prescribed.
A nurse is caring for a client who claims to be spiritual but is addicted to drugs. Which of the following factors contribute to the spiritual health of a client? Select all that apply. a) Firm spiritual identity b) Appropriate religious education c) Sound economic status d) Adaptable belief system e) Sense of being powerful
Correct response: • Appropriate religious education • Adaptable belief system • Firm spiritual identity
1.When a nurse asks himself or herself questions such as "Why am I here?," the nurse is attempting to A)Develop the concepts of holism and integration B)Become a more spiritual being for other people C)Develop a philosophical base for clearer thinking D)Strive toward unity with the higher power
Develop a philosophical base for clearer thinking
An obese client tells the nurse that he plans to buy an abdominal exerciser to cut down on his weight and give his body a more aesthetic look. The nurse should identify this as what level of valuing? a) Foundation value. b) Moral value. c) Future value. d) Focus value.
Future Value
A child with leukemia had been in remission for several years, but death is now imminent. The nurse is assisting the parents as they prepare for the child's death. Which approach will be most helpful? a) Help parents understand that grief is stronger when preceded by hope. b) Understand the parent's trust in the health care system will be undermined by the death of their child. c) Reflect to the parents that the death of a child is more difficult than that of an adult. d) Recognize that the parents have been prepared for this death since the time of diagnosis.
Help parents understand that grief is stronger when preceded by hope.
What question would the nurse ask to assess coping abilities of a family dealing with a chronic illness? a) What is the best way your family resolves crisis situations? b) Does your family have the strength to deal with the changes and still support you through this difficult time? c) Has your family been able to handle chronic illness management before? d) How is your condition affecting your family members and their usual roles?
How is your condition affecting your family members and their usual roles?
The nurse is aware that clients who are Christian Scientists may not approve of a) Circumcisions b) Contraception c) Expensive treatments d) Immunizations
Immunizations
A group of nursing students are reviewing current nursing Codes of Ethics. Such a code is important in the nursing profession because: a) Nurses are highly vulnerable to criminal and civil prosecution in the course of their work. b) Nursing practice involves numerous interactions between laws and individual values. c) Nurses interact with clients and families from diverse cultural and religious backgrounds. d) Nurses are responsible for carrying out actions that have been ordered by other individuals.
Nursing practice involves numerous interactions between laws and individual values.
A client with a fetal demise at 40 weeks asks the nurse, "How could God let this happen?" An appropriate goal for the client with a nursing diagnosis of "spiritual distress related to infant loss as verbalized by the client" would be that the client will
Participate in supportive spiritual practices.
A nurse assesses spirituality to gain an understanding of what in relation to the client's life? a) Possible coping mechanisms b) Sense of meaning and purpose c) Common practices shared with a group d) Meaning of afterlife
Possible copiong mechanisms
informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he pays her. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior called: a) Quid pro quo harassment. b) Environmental harassment. c) Hostile environment harassment. d) Fetishism.ur infant's condition takes time to heal."
Quid pro Quo harrassment
While assessing a primigravid client admitted at 36 weeks' gestation, the nurse observes multiple bruises on the client's face, neck, and abdomen. When asked about the bruises, the client admits that her boyfriend beats her now and then and says, "I want to leave him because I am afraid he will hurt the baby." Which action is the nurse's most appropriate response? a) Ask the client when she last felt the baby move. b) Tell the client to leave the boyfriend immediately. c) Refer the client to a social worker for possible options. d) Report the incident to the unit nursing supervisor.
Refer the client to a social worker for possible options
A usually reliable interpreter called by the nurse to help communicate with a mother of a child who does not speak English and has brought her child in for a routine visit has yet to arrive in the clinic. The nurse has paged the interpreter several times. What should the nurse do next? a) Continue with the examination. b) Page the interpreter one more time. c) Ask the mother to stay longer in the hope that the interpreter arrives. d) Reschedule the infant's appointment for later in the week.
Reschedule the infant's appt. for later in the week
A nurse cares for a client who states that he believes that God can be seen in everything and every action. The nurse recognizes this as what characteristic of spirituality? a) Organized b) Self-reflective c) Objective d) Ritualistic
Self-Reflective
The nurse is caring for a client admitted to a medical surgical unit. Which of the following situations would indicate a professional nurse's boundary violation? Select all that apply. a) Speaking to the client's family about a diagnosis without permission from the client b) Sharing a personal experience with a client that is very similar to the situation the client is experiencing c) Reminding a client who has dementia that certain sexual touch behaviors are not acceptable d) Having well-intentioned behaviors that detract from achievable health outcomes for clients e) Being concerned about a client's welfare and seeking ways to protect them
Sharing a personal experience with a client that is very similar to the situation the client is experiencing • Speaking to the client's family about a diagnosis without permission from the client • Having well-intentioned behaviors that detract from achievable health outcomes for clients
The client with an abdominal hysterectomy is being prepared for discharge in the morning. The client has a handicapped adult son whom she cares for at home. The nurse should discuss with the health care provider (HCP) the need for referral to: a) pastoral care. b) social work. c) home health care. d) volunteer services.
Social Work
A dying patient requests that the nurse pray with him. The nurse is not accustomed to praying aloud but is comfortable praying silently. What is the best approach for this nurse to follow to pray with this patient? a) The nurse should inform the patient that he or she will pray for but not with the patient. b) The nurse should defer the patient's request to pray. c) The nurse should ask the patient's roommate to pray with the patient. d) The nurse should select a formal prayer or Bible passage to use to pray aloud.
The nurse should select a formal prayer or Bible passage to use to pray aloud.
Upon assessment, the nurse is addressing the beliefs of a newly admitted man who reports practicing the Adventist religion. Based upon the nurse's familiarity with this religion, she appropriately asks the patient: a) "What are your beliefs about the use of narcotics for pain?" b) "Is it acceptable for the healthcare team to remove undergarments in an emergency?" c) "Do you receive care from a medicine man or woman?" d) "What are your beliefs about blood transfusion?"
What are your beliefs about the use of narcotics for pain
A client has identified to the community mental health nurse that an inability to be assertive with the client's boss has contributed to long work hours and increased stress and anxiety. To assist the client, which of the following questions would be most appropriate for the nurse to ask? a) "How is it best for you to approach your boss?" b) "What have you done so far to try to solve this problem?" c) "What are your alternative plans at this time?" d) "When is the best time of day to approach your boss?"
What have you done so far to try to solve this problem
An older adult with end-stage cancer needs assistance with arranging the finances for end-of-life home care. The nurse should refer the client to: a) the health care provider (HCP). b) the executor of the client's will. c) a social worker. d) the business manager of the health care agency.
a social worker
While meeting with the nurse, a client's wife states, "I do not know what else to do to make him stop drinking." The nurse should refer the wife to which organization? a) Al-Anon b) Alateen c) Alcoholics Anonymous d) an employee assistance program
aL-ANON
Which goal is an expected outcome for a client recovering from a total laryngectomy? The client will: a) demonstrate appropriate care of the gastrostomy tube. b) regain the ability to taste and smell food. c) communicate feelings about body image changes. d) demonstrate sterile suctioning technique for stoma care.
communicate feelings about body image changes
A patient from Pakistan informs the nurse of his cultural dietary requests. The nurse responds to the special dietary needs by stating, "You are now living in the United States, and you should try to start eating those foods common to an American diet." This inappropriate response is an example of: a) Cultural assimilation. b) Cultural blindness. c) Cultural imposition. d) Cultural diversity.
cultural imposition
A client who comes to the crisis center in a very distressed state tells the nurse, "I just cannot get over being fired last week. I have asked for help. I have talked to friends. I have tried everything to get through this, but nothing is working. Help me!" Which initial crisis intervention strategy should the nurse use? a) referral for counseling b) support system assessment c) emotion management d) unemployment assistance
emotion management
A client in a general hospital is to undergo surgery in 2 days. He is experiencing moderate anxiety about the procedure and its outcome. To help the client reduce his anxiety, the nurse should: a) tell the client to distract himself with games and television. b) explain the surgical procedure to the client and what happens before and after surgery. c) reassure the client that he will come through surgery without incident. d) ask the surgeon to refer the client to a psychiatrist who can work with the client to diminish his anxiety.
explain the surgical procedure to the client and what happens before and after surgery.
Which activity would be most appropriate to include in a playroom that will be used by children aged 13 months to 6 years? a) a group sing-along b) viewing cartoon videos c) free play with adult supervision d) drawing and painting projects
free play with supervision
An 80-year-old woman who identifies herself as a devout Catholic has recently relocated to an assisted-living facility. The woman is pleased with most aspects of her new living situation, but laments the fact that she is no longer close to the church where she was in the habit of attending daily mass each morning. What nursing diagnosis may apply to this problem that the woman has identified? a) Hopelessness b) Impaired Religiosity c) Spiritual Pain d) Spiritual Distress
impaired Religiosity
Which philosophy should the nurse integrate into the plan of care for a client and family to help them best cope during the final stages of the client's illness? a) expecting the worst and being grateful when it does not happen b) reliving the pleasant memories of days gone by c) planning ahead for the remaining good times that will be spent together d) living each day as it comes as fully as possible
living each day as it comes as fully as possible
The 65-year-old widower whose only son is 500 miles (800 km) away is at higher risk for psychosocial distress because the client: a) is able to use denial as a coping mechanism. b) perceives he has minimal social support. c) does not have to deal with other stressors right now. d) has been successful in dealing with stress all his life.
perceives he has minimal social support
A nurse is administering a prescribed dose of an injection to a middle-aged client with Bell's palsy. What are the sources of fulfillment in the middle-years of an adult client's life? a) Productive activity b) Advanced study c) Personal experiences d) Sense of faith
productive activity
A nurse has attended an in-service workshop to address the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism? a) Providing slightly smaller servings of food for clients who are elderly. b) Speaking to older adults in a way one would with clients who have mild cognitive deficits. c) Implementing falls prevention measures in a setting where older adults receive care. d) Assessing the skin turgor of older adults differently than for younger adults.
speaking to older adults in a way one would with clients who have mild cognitive deficits
The parents of an infant who just died from sudden infant death syndrome (SIDS) are angry at God and refuse to see any members of the clergy. Which nursing diagnosis is most appropriate? a) Chronic sorrow b) Complicated grieving c) Spiritual distress d) Ineffective coping
spiritual distress
A stable older adult client is comatose following a cerebral vascular accident. The primary healthcare provider believes a gastrostomy tube should be placed for long-term nutrition. No family members have been located. Which of the following should be done to obtain informed consent for the procedure? a) The primary healthcare provider may act without consent to save the client's life. b) The attorney who prepared the client's last will and testament may sign the consent. c) The nurse should contact the person identified as the healthcare power of attorney. d) The client's do-not-resuscitate (DNR) order denies consent for the procedure.
the nurse should contact the person identified as the healthcare power of attorner
The nurse is trying to establish a trusting relationship with a client experiencing pain. When the client asks for pain medication, the nurse notes that it is not time to give the medication. What is the best action by the nurse to facilitate a trusting relationship? a) Tell the client when the medication is due and return promptly at that time. b) Tell the client how unfortunate the situation is and offer distraction. c) Tell the client that a more experienced nurse will administer the pain medication. d) Tell the client a personal story about difficulty managing pain.
the the client when the medication is due and return promptly at that time OR tell the client a personal story about difficulty managing pain
The nurse is preparing written information for an older adult who is to manage intermittent self-catheterization. Which strategy will be most effective? a) Print the material in a condensed font. b) Prepare information at an tenth-grade reading level. c) Use short words. d) Use charts to help convey information.
use short words
When providing nursing care to a client of African descent, which of the following cultural factors should the nurse consider? a) Families are highly competitive. b) They possess weak religious affiliations. c) Families are usually patriarchal. d) Values and beliefs are often present oriented.
values and beliefs are often present oriented
The nurse is caring for a client who developed fluctuating moods related to a recent cerebral vascular accident. When discussing the client's mood in a family meeting, which statements confirm a family's understanding of how to support the client? Select all that apply. a) "I do not take what she says personally and try to address the issue of anger." b) "Sometimes I sit down and cry too then we pick ourselves up and move on." c) "All the kids just leave the room if she gets emotional, that provides privacy." d) "I tell her how I feel and yell back if needed so not to keep all of my frustration inside." e) "I allow her to vent feelings and then find a different topic to discuss.
• "I do not take what she says personally and try to address the issue of anger." • "I allow her to vent feelings and then find a different topic to discuss." • "Sometimes I sit down and cry too then we pick ourselves up and move on."
A nurse calls the unit manager to report that her purse has been stolen from the locked break room. The nurse says she thinks she knows which of the staff stole the purse. Which actions by the nurse manager would be appropriate? Select all that apply. a) Confront the person the nurse suspects stole the purse. b) Ask other staff to report any suspicious activity they may have observed. c) Alert nursing administration that a staff's purse has been stolen. d) Ask the nurse to document all the facts related to the missing purse. e) Call hospital security to initiate an investigation.
• Ask other staff to report any suspicious activity they may have observed. • Alert nursing administration that a staff's purse has been stolen. • Ask the nurse to document all the facts related to the missing purse. • Call hospital security to initiate an investigation.
A nurse is caring for a middle-aged client who has undergone hemicolectomy for colon cancer. The client has two children. Which concepts about families would the nurse consider when providing care for this client? Select all that apply. a) Family roles do not change because of illness. b) Children typically are not affected by adult illness. c) Changes in sleeping and eating patterns may be signs of stress in a family. d) A family member may have more than one role at a time in the family. e) Illness in one family member can affect all family members. f) The effects of an illness on a family depend on the stage of the family's life cycle.
• Illness in one family member can affect all family members. • A family member may have more than one role at a time in the family. • The effects of an illness on a family depend on the stage of the family's life cycle. • Changes in sleeping and eating patterns may be signs of stress in a family.
A nurse is caring for a client who is disoriented to time, place, and person and is attempting to get out of bed and pull out an intravenous line. The nurse receives orders from a health care provider to apply a vest restraint and bilateral soft wrist restraints. In carrying out this order, which nursing actions would be appropriate? Select all that apply. a) Tie the restraints in quick-release knots. b) Tie the restraints to the side rails of the bed. c) Document the client's response to the intervention. d) Document alternative methods used before the restraints were applied. e) Document the client's condition. f) Perform a face-to-face behavior evaluation every hour.
• Perform a face-to-face behavior evaluation every hour. • Tie the restraints in quick-release knots. • Document the client's condition. • Document alternative methods used before the restraints were applied. • Document the client's response to the intervention.
A client with chronic renal failure was recently told by the healthcare provider of being a poor candidate for a transplant because of chronic uncontrolled hypertension and diabetes mellitus. Now the client tells the nurse, "I want to go off dialysis. I'd rather not live than be on this treatment for the rest of my life." Which responses are appropriate? Select all that apply. a) Say to the client, "We all have days when we don't feel like going on." b) Say to the client, "The treatments are only 3 days a week. You can live with that." c) Leave the room to allow the client privacy to collect thoughts. d) Say to the client, "You're feeling upset about the news you got about the transplant." e) Take a seat next to the client and sit quietly to reflect on what was said.
• Say to the client, "You're feeling upset about the news you got about the transplant." • Take a seat next to the client and sit quietly to reflect on what was said.
A nurse is caring for a spiritually distressed client. Which of the following are the factors affecting spiritual distress? Select all that apply. a) Self-alienation. b) Ability to introspect. c) Chronic illness. d) Sociocultural deprivation. e) Seeing a religious leader.
• Self-alienation. • Chronic illness. • Sociocultural deprivation.
The home health nurse is completing the admission paperwork for a new client diagnosed with osteomyelitis who will be receiving home service intravenous therapy for the next month. The client is 32 years old and happily married. Which of the following findings will warrant further investigation? Select all that apply. a) The client spends a great deal of time reflecting back on teen years. b) The client reports having many hobbies and interests outside of the home. c) The client is talkative about the spouse and children. d) The client voices concerns about recovering quickly to return to work in the next month. e) The client talks repeatedly about the inability to grow old with his/her spouse.
• The client talks repeatedly about the inability to grow old with his/her spouse. • The client spends a great deal of time reflecting back on teen years.