NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 851:

  The nurse who was not promoted tells another friend, "I knew I'd never get the job. The hospital administrator hates me."

  If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating __________.

  A. compensation

  B. reaction formation

  C. projection

  D. denial

  Correct Answer: C

  Projection results in unconsciously adopting blaming behavior. It attributes unacceptable attributes to other people. Compensation results in the nurse unconsciously attempting to emphasize a strong point in an attempt to

  make up for a perceived weakness.

  Reaction formation unconsciously adopts behavior that is opposite her actual feelings.

  Denial involves ignoring the existence of an unpleasant reality.

• Question 852:

  Two staff nurses were considered for promotion to head nurse. The promotion is announced via a memo on the unit bulletin board. The nurse who was not promoted tells a friend, "Oh, well, I really didn't want the job anyway."

  This is an example of __________.

  A. rationalization

  B. denial

  C. projection

  D. compensation

  Correct Answer: A

  This is called the sour grapes form of rationalization. Rationalization is an unconscious form of self-

  deception in which excuses are made.

  Denial is an unconscious process that ignores the existence of the situation.

  Projection operates unconsciously and results in blaming behavior.

  Compensation is an attempt to make up for a perceived weakness by emphasizing a strong point.

• Question 853:

  An adult who had been abused as a child is discussing the group therapy program.

  Which statement indicates that the client has gained insight?

  A. "I think I was a lonely child because I could not tell anyone about my abuse."

  B. "I am now aware of how deep-seated my anger is. Before I did not realize I was angry."

  C. "The program has given me the courage to tell my mother how I felt about her role in my hurt."

  D. "There are so many people just like me, who are just normal people that had bad things happen to them."

  Correct Answer: B

  Children who are abused learn to cope with the painful experiences by ignoring painful feelings and avoiding getting close to people. As adults, victims of abuse usually continue to repress feelings, avoid close interpersonal relationships, and frequently use alcohol or drugs to block painful memories. Long-term effects in adults might include criminal/violent behavior (for adult males), substance abuse, and a variety of social and emotional problems (including suicidal thoughts, anxiety, hostility, dissociation, and interpersonal difficulties).

• Question 854:

  The highest incident of child abuse occurs in children in which age group?

  A. 3-year-old

  B. 4-6-year-old

  C. 6-10-year-old

  D. more than 10-year-old

  Correct Answer: A

  Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000

  children).

  Girls are slightly more likely to be victims than boys.

• Question 855:

  A client receiving preoperative instructions asks questions repeatedly about when to stop eating the night before the procedure. The nurse tries to refocus the client. The nurse notes that the client is frequently startled by noises in the hall. Assessment reveals rapid speech, trembling hands, tachypnea, tachycardia, and elevated blood pressure. The client admits to feeling nervous and having trouble sleeping.

  Based on the assessment, the nurse documents that the client has __________.

  A. mild anxiety

  B. moderate anxiety

  C. severe anxiety

  D. a panic attack

  Correct Answer: C

  In severe anxiety, a client focuses on small or scattered details. The person is unable to solve problems.

  With mild anxiety, stimuli are readily perceived and processed, and the ability to learn and solve problems

  is enhanced.

  Moderate anxiety narrows the perceptual field, but the client notices things brought to his attention.

  During a panic attack, the person is disorganized and might be hyperactive or unable to speak or act.

• Question 856:

  A family member of a client with a diagnosis of Schizophrenia asks about the prognosis.

  The nurse's response is based on the knowledge that schizophrenia __________.

  A. affects women more often than men

  B. is usually diagnosed between the ages of 15 and 45

  C. is a chronic, deteriorating disease with periods of remission

  D. is diagnosed later in women due to a protective hormone effect

  Correct Answer: C

  Although all of the choices are true about schizophrenia, only Choice "is a chronic, deteriorating disease with periods of remission" answers the question asked.

• Question 857:

  Which of the following services is not part of family consultation?

  A. assisting with vocational rehabilitation

  B. providing information about the client's illness

  C. teaching effective communication

  D. helping families solve problems

  Correct Answer: A

  Family consultation does not involve vocational rehabilitation. It involves helping families deal with their feelings, focus, and find solutions. Choices "providing information about the client's illness", "teaching effective communication" and "helping families solve problems" are components of family consultation.

• Question 858:

  The nurse is developing a care plan for a client with severe anxiety.

  An appropriate outcome for the client is that within 4 days the client should __________.

  A. Have decreased anxiety

  B. Talk to the nurse for 10 minutes

  C. Sit quietly for 30 minutes

  D. Develop an adaptive coping mechanism

  Correct Answer: B

  Outcome criteria need to be specific, measurable, and realistic.

  Talking for 10 minutes meets all of these conditions.

  It is not realistic to expect a severely anxious client to sit quietly for 30 minutes.

  The other statements are vague and not measurable.

• Question 859:

  A client reports that someone is in the room and trying to kill him.

  The nurse's best response is __________.

  A. "No one is in your room. Let's get you more medicine."

  B. "I do not see anyone, but you seem to be very frightened."

  C. "No one can hurt you here."

  D. "Just tell the person to go away."

  Correct Answer: B

  It is important to acknowledges the client's fear. The other responses deny the client's perceptions.

• Question 860:

  A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else.

  Which of the following comments by the nurse to the physician is appropriate?

  A. "Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain."

  B. "Often women become offended if asked about their safety in relationships."

  C. "It is mandatory that all women be questioned about domestic violence."

  D. "How would you feel to know that her partner is beating her and you didn't ask?"

  Correct Answer: A

  There is a correlation between vague symptoms, such as abdominal pain, and battered syndrome. The astute clinician should question any woman who presents with suspicious symptoms such as these. Rarely are women offended by a properly worded question, such as, "Do you feel safe in your present relationship?" Studies show an increase in case finding when such questions are asked. It is not mandatory that all women are assessed for violence, but it is prudent that all persons new to a clinician be assessed by at least the one question noted previously. Castigating or shaming the physician typically does not improve client outcomes and might make for a difficult working environment for the nurse. Tactless comments, like the Choice "How would you feel to know that her partner is beating her and you didn't ask?", are not collegial and should be avoided.