NCLEX-RN Psychosocial Integrity Exam

A client recently laid off from work states, “I am worried that I cannot keep up with my responsibilities at home, and I do not know how I will pay my bills.”

> Which nursing diagnosis is the highest priority?

A client has just been diagnosed with type 2 diabetes mellitus. The nurse is assessing readiness to learn before beginning teaching on glucose monitoring.

> Which client behavior indicates a lack of readiness to learn?

A client diagnosed with peptic ulcer disease reports that symptoms worsen during stressful periods at work.

> Which situation described by the client is most likely contributing to exacerbations?

A client appears anxious before a scheduled cast removal and states, “That machine sounds like it will cut my arm.”

> Which action by the nurse is most helpful?

A client’s tuberculin skin test converts from negative to positive. The client is upset and asks what this result means.

> The nurse bases the explanation on which interpretation?

A nurse is caring for a dying client whose family members are gathered at the bedside.

> Which communication strategies are therapeutic? Select all that apply.

The parent of a 5-year-old asks whether the child should attend their grandparent’s funeral, noting disagreement within the family.

> Which is the best nursing response?

A nurse evaluates a parent four weeks after delivery and is assessing for postpartum depression.

> Which observation would require follow-up?

A client with severe peripheral vascular disease is told that a leg amputation is necessary. The client becomes angry and says, “This is all the surgeon’s fault.”

> How should the nurse interpret this reaction?

A client being treated for alcohol use disorder asks about medications that can help maintain sobriety after detoxification.

> Which medication would the nurse most likely discuss?

During a substance-use risk assessment, a client reports that two close biological relatives struggled with addiction.

> Which factor would the nurse identify as a primary biological risk?

A client with a history of aggressive outbursts begins pacing quickly, clenching fists, and shouting at others on the unit.

> Which nurse statement is most therapeutic?

A client awaiting surgery says, “I am nervous. I do not know what to expect, and I am scared something will go wrong.”

> Which nurse response is most likely to encourage further discussion?

A client says, “Government agents are watching me and are planning to eliminate me.”

> Which nurse response is most therapeutic?

A client newly admitted with bulimia nervosa is undergoing a physical assessment.

> Which findings would the nurse expect? Select all that apply.

A client admitted after expressing suicidal intent states, “I cannot handle anything anymore. I do not care what happens to me.”

> What is the priority nursing action?

A client recovering from colostomy creation expresses concerns about appearance and independence.

> Which client behavior demonstrates the greatest progress toward acceptance?

A client scheduled for left nephrectomy due to renal cell carcinoma expresses fear about needing dialysis afterward.

> Which information should the nurse provide?

A nurse is speaking with a parent of a terminally ill child.

> Which response indicates the caregiver needs more teaching regarding palliative care?

A client transitioning from exclusive enteral tube feedings to partial oral intake expresses worry about managing supplemental tube feedings independently at home.

> What is the nurse’s best response?