Psychosocial Integrity — NCLEX-RN Practice
Covers coping mechanisms, mental health concepts, grief and loss, abuse and neglect, chemical dependency, and therapeutic communication techniques.
Practice Psychosocial Integrity with PassMate AI →Key Points to Know
What you must know about Psychosocial Integrity
Therapeutic communication questions almost always reward open-ended, client-centered responses over closed or advice-giving ones.
Never select an answer that dismisses, minimizes, or argues with the client’s feelings.
Abuse and neglect questions test the nurse’s duty to report and to prioritize client safety over confidentiality.
Grief questions expect recognition that grief is individual — there is no fixed "correct" stage to expect.
NCLEX Exam Tips
How this category appears on the NCLEX-RN exam
If an answer choice starts with "why," it is almost always wrong — "why" questions put the client on the defensive.
For a client expressing suicidal ideation, direct, specific questioning about a plan is the correct next action, not avoidance.
Practice Questions
Test yourself — 10 questions
Practice questions written to the NCSBN NCLEX-RN test plan. The NCSBN does not publish real exam items, so no provider has genuine NCLEX past questions. Every question here comes with a full written rationale.
A 32-year-old client is admitted to the psychiatric unit with a diagnosis of major depressive disorder. The client reports feeling hopeless and having no interest in activities they once enjoyed. The client expresses thoughts of life not being worthwhile. What is the nurse's priority action?
Rationale
The priority in this scenario is to assess for suicide risk, as the client expresses feelings of hopelessness and worthlessness, which are significant risk factors for suicide. Encouraging group therapy or discussing medications can be part of the care plan but are not the immediate priority. Providing a list of activities is not appropriate when the client feels life is not worthwhile.
A 45-year-old client with schizophrenia is experiencing auditory hallucinations and is admitted to the psychiatric unit. The client reports that the voices are commanding them to harm others. What is the most appropriate initial nursing intervention?
Rationale
Assessing the content of the hallucinations is crucial to determine the level of threat and appropriate interventions. Engaging in a discussion about hobbies does not address immediate safety concerns. Seclusion is not the first step unless the client poses an immediate threat. Administering medication may be necessary but follows assessment.
A nurse is caring for a 30-year-old client diagnosed with generalized anxiety disorder who has started a cognitive-behavioral therapy program. The client expresses doubt about the effectiveness of the therapy. What is the nurse's best response?
Rationale
It is important to remind the client that progress in therapy can be gradual, setting realistic expectations. Assuring therapy is always effective is misleading. Suggesting medication undermines the current therapy approach. Encouraging discussion with the therapist is helpful but does not directly address the client's concern.
A 70-year-old client with a recent diagnosis of Alzheimer's disease is becoming increasingly agitated in the late afternoon. What intervention should the nurse implement to address the client's agitation?
Rationale
Engaging the client in a calming activity can help reduce agitation. Offering food or drink may not address the underlying cause of agitation. Napping might disrupt the client's sleep-wake cycle. Medication dosage changes must be carefully monitored and not increased without specific instructions.
A 45-year-old client with a history of schizophrenia is being discharged from the hospital. The client is currently stable on antipsychotic medication and has a supportive family environment. What is the most important aspect of discharge planning for this client?
Rationale
Ensuring a follow-up appointment with the psychiatrist is crucial for maintaining medication management and monitoring mental health status post-discharge. Encouraging hobbies, providing support group information, and medication education are beneficial but secondary to ensuring continuity of care.
A nurse is caring for a 30-year-old client experiencing a panic attack in the emergency department. Which intervention should the nurse implement first?
Rationale
Instructing the client to take slow, deep breaths is an immediate intervention to help reduce anxiety and manage hyperventilation. Administering medication is important but comes after non-pharmacological interventions. Discussing feelings is more appropriate once the client is calm. Leaving the client alone may increase anxiety.
A client with depression has been admitted to the psychiatric unit. The client expresses feelings of hopelessness and states, 'I can't go on like this anymore.' What is the nurse's priority action?
Rationale
Asking about specific plans for self-harm is crucial to assess the risk of suicide and ensure immediate safety interventions if needed. Providing reassurance and support, encouraging group therapy, and notifying family are important but secondary to assessing suicide risk.
A 22-year-old female client with anorexia nervosa is admitted for inpatient treatment. Which finding would most likely indicate improvement in her condition?
Rationale
Gaining weight is a concrete indicator of improvement in a client with anorexia nervosa. Feeling less anxious, participating in therapy, and understanding dietary needs are positive signs but do not directly measure improvement in nutritional status.
A nurse is conducting a mental status exam on a client who has been diagnosed with bipolar disorder. The client is currently experiencing a manic episode. What behavior is most characteristic of this state?
Rationale
Rapid, pressured speech is characteristic of a manic episode, reflecting heightened energy and mood. Depressive mood, lack of energy, and social withdrawal are more associated with depressive episodes.
A client with post-traumatic stress disorder (PTSD) is attending therapy sessions. The client reports having nightmares and flashbacks. Which intervention should the nurse prioritize to help the client manage these symptoms?
Rationale
Teaching relaxation techniques and using a safety plan can help manage symptoms of PTSD, such as nightmares and flashbacks. Avoidance of trauma reminders, increasing social activities, and advising against discussing trauma do not address the symptoms directly and can be counterproductive.
Want unlimited practice on Psychosocial Integrity? Practice with PassMate →
Related NCLEX topics to study
Master Psychosocial Integrity with AI
Ask PassMate unlimited questions about this category. Instant explanations, available 24/7.
Start Free Trial →Also preparing for NMCN? Explore NMCN prep →