RN Psychosocial Integrity 1 — Questions and Answers
Question 1: A patient newly diagnosed with breast cancer states, 'I can't believe this is happening to me.' The nurse's best therapeutic response is:
- 'Many people survive breast cancer with treatment.'
- 'This must be very frightening. Would you like to talk about how you're feeling?' (Correct answer)
- 'You should stay positive; attitude affects outcomes.'
- 'Let me get you some pamphlets about breast cancer.'
Correct answer: 'This must be very frightening. Would you like to talk about how you're feeling?'
Acknowledging the patient's fear and inviting open dialogue is the most therapeutic response, demonstrating empathy and patient-centered communication.
Question 2: Which behavior indicates a patient is in the bargaining stage of Kübler-Ross's stages of grief?
- Refusing to discuss the terminal diagnosis
- 'If I follow every treatment, maybe I'll see my grandchild born.' (Correct answer)
- Crying and expressing feelings of hopelessness
- Asking questions about hospice care
Correct answer: 'If I follow every treatment, maybe I'll see my grandchild born.'
Bargaining involves making deals or promises in exchange for more time or a change in outcome, as seen in the statement about surviving to witness a grandchild's birth.
Question 3: A patient with schizophrenia tells the nurse, 'The CIA has implanted a chip in my brain to control my thoughts.' The nurse's best response is:
- 'That sounds frightening. I don't share that belief, but I'm here to help you stay safe.' (Correct answer)
- 'That is impossible; there are no chips in your brain.'
- 'Tell me more about the CIA and why they would do that.'
- 'You need to take your medication so these thoughts will stop.'
Correct answer: 'That sounds frightening. I don't share that belief, but I'm here to help you stay safe.'
The nurse should neither argue with the delusion nor reinforce it, but acknowledge the patient's distress and provide reality orientation while maintaining therapeutic rapport.
Question 4: A patient with major depressive disorder says, 'I've been giving my belongings away and I feel at peace now.' The nurse's priority action is:
- Praise the patient for achieving inner peace
- Conduct an immediate suicide risk assessment (Correct answer)
- Notify social work for discharge planning
- Document the finding and continue monitoring
Correct answer: Conduct an immediate suicide risk assessment
Giving away possessions and sudden calmness in a depressed patient are high-risk warning signs of suicidal intent requiring immediate safety assessment.
Question 5: When using motivational interviewing to help a patient with alcohol use disorder, which statement best reflects the technique?
- 'You need to stop drinking before it kills you.'
- 'What would your life look like if you reduced your alcohol use?' (Correct answer)
- 'I'll schedule you for an AA meeting tomorrow.'
- 'Your family is very worried about your drinking.'
Correct answer: 'What would your life look like if you reduced your alcohol use?'
Motivational interviewing uses open-ended questions to help patients explore their own motivation for change, evoking internal ambivalence rather than imposing external pressure.
Question 6: A nurse is caring for a patient who experienced sexual assault. Which statement by the nurse is most therapeutic?
- 'You should report this to the police right away.'
- 'I believe you. What happened was not your fault, and you are safe here.' (Correct answer)
- 'Can you tell me exactly what happened so I can document it accurately?'
- 'Were you drinking before the assault occurred?'
Correct answer: 'I believe you. What happened was not your fault, and you are safe here.'
Validating the patient's experience, assigning no blame, and reassuring safety are foundational trauma-informed care principles for sexual assault survivors.
