Free NCLEX-RN Psychosocial Integrity Questions
Free NCLEX-RN psychosocial integrity practice questions with rationales — coping, therapeutic communication, and mental health care.
Which principles guide crisis intervention? Select all that apply.
Correct answers: o1, o2, o3, o5
Crisis intervention focuses on the immediate problem, ensures safety, mobilizes coping and support, and uses an active, directive approach because time is short. Deep exploration of the past and long-term personality change are goals of ongoing therapy, not acute crisis work.
Why the other options are wrong
- o4. Exploring the distant past is a goal of long-term insight-oriented therapy. Key distinction: Crisis intervention is brief and focuses exclusively on the immediate precipitating stressor.
- o6. Long-term personality reconstruction requires months or years of psychotherapy. Key distinction: The objective of crisis intervention is to restore the client to their pre-crisis baseline, not to alter their personality.
Key takeaway: Crisis intervention: present-focused, safety, mobilize support, and active/directive.
A client with schizophrenia says, 'The voices are telling me that I am in danger.' Which response by the nurse is most appropriate?
Correct answer: D
The nurse validates the client's feeling (fear) while being honest that the nurse does not hear the voices, which builds trust without reinforcing the hallucination. Arguing that the voices are not real tends to increase distress, dismissing them ('just tell them to stop') is not helpful, and the nurse does assess for command hallucinations but not by focusing on harming others in this phrasing.
Why the other options are wrong
- A. Flatly denying the voices puts you in an argument the client cannot win from inside the experience, which usually deepens distress and erodes trust. Key distinction: be honest about your own perception without declaring the client wrong.
- B. Leading with what the voices say about harming others centers other people instead of the client's fear and safety, and the abrupt focus can feel threatening. Key distinction: assess command hallucinations, but open with the client's emotion, not with harm to others.
- C. Telling the client to just dismiss the voices minimizes an experience they cannot switch off and offers no real support. Key distinction: acknowledge the distress rather than instruct the client to override it.
Key takeaway: With hallucinations, acknowledge the client's feeling and state you do not share the perception, without arguing.
A client with schizophrenia states firmly, "The government planted a tracking chip in my arm." Which response by the nurse is most appropriate?
Correct answer: C
The nurse neither argues with nor reinforces a delusion. The best response presents reality without debating it ("I do not see a chip") while acknowledging the client's feeling ("this is frightening for you"). Directly arguing the delusion puts the client on the defensive, asking for more detail explores and reinforces the delusional content, and offering an x-ray to disprove it engages the delusion as if it were testable, which also reinforces it.
Why the other options are wrong
- A. Arguing the delusion makes the client defensive and does not build trust.
- B. Even when paired with empathy, asking about the chip explores and reinforces the delusional content.
- D. Trying to disprove the delusion with a test engages and reinforces it.
Key takeaway: With a delusion, do not argue it, explore its content, or try to disprove it. Acknowledge the underlying feeling and calmly present reality.
A client appears frightened and says, 'The voices are telling me people want to hurt me.' What is the nurse's best response?
Correct answer: C
The nurse acknowledges the client's reality without confirming the hallucination ('I don't hear them') and, most importantly, assesses for command hallucinations that direct harm, which is the immediate safety concern. Denying the voices argues with the client, exploring their content in detail can reinforce them, and telling the client to ignore them dismisses the experience.
Why the other options are wrong
- A. Flatly denying the voices argues with the client's experience and does not build trust or assess safety.
- B. Exploring the content in detail can reinforce the hallucination and misses the safety question.
- D. Telling the client to ignore the voices dismisses a frightening experience and assesses nothing.
Key takeaway: For hallucinations, do not confirm or argue. Acknowledge the client's experience and assess for command hallucinations that direct harm.
A client is admitted with anorexia nervosa. Which nursing interventions are appropriate? Select all that apply.
Correct answers: o1, o2, o3
Care supervises meals and the period after to prevent purging or hiding food, monitors electrolytes for the dangerous shifts of refeeding, and keeps a neutral tone that avoids power struggles over food and weight. Leaving eating optional, allowing free exercise, and praising weight gained all feed the disorder or add danger.
Why the other options are wrong
- o4. Making meals optional lets the eating disorder control intake.
- o5. Free exercise burns needed calories and can be used to counteract eating.
- o6. Praising weight focuses on the number and can increase the client's distress and resistance.
Key takeaway: Supervise meals and the time after, watch refeeding electrolytes, and stay matter-of-fact. Do not make eating optional, allow free exercise, or praise the weight.
A client stopped drinking alcohol about 24 hours ago. Which findings are consistent with alcohol withdrawal? Select all that apply.
Correct answers: o4, o1, o3, o2
Alcohol withdrawal is a state of nervous-system overactivity, so it produces tremors, a fast heart rate, high blood pressure, and sweating, along with anxiety and a risk of seizures, and the pupils dilate. Pinpoint pupils suggest opioid effect, slurred speech with an unsteady gait describes intoxication rather than withdrawal, and diaphoresis means the skin is sweaty rather than flushed and dry.
Why the other options are wrong
- o5. Alcohol withdrawal dilates the pupils as part of autonomic overactivity; pinpoint pupils instead point to opioid effect and do not fit withdrawal.
- o6. Slurred speech and an unsteady gait describe acute intoxication. As alcohol clears, the nervous system becomes overactive rather than sedated and uncoordinated.
- o7. Withdrawal produces diaphoresis, so the skin is sweaty, not dry. Flushed, dry skin suggests another cause such as an anticholinergic effect or heat exposure.
Key takeaway: Alcohol withdrawal is sympathetic overdrive: tremor, tachycardia, hypertension, diaphoresis, and dilated pupils. Pinpoint pupils, slurred speech with an unsteady gait, and dry skin point elsewhere.