Practice Psychosocial Integrity questions for the National Council Licensure Examination — RN. Every question includes a full explanation of why the correct answer is right and why the tempting distractors are wrong.
47 questions available · medium difficulty · NCLEX-RN · Free, no registration required
10 example questions with full explanations. Use the interactive practice above to work through the complete set.
Question 1easy
A nurse is caring for a patient who says, 'I've been feeling really hopeless lately.' Which response by the nurse is MOST therapeutic?
- A."Why do you feel hopeless? You have so much to live for."
- B."Don't worry, things will get better soon."
- C."Tell me more about what you've been feeling."✓
- D."Have you tried talking to your family about this?"
Correct answer: C
Open-ended statements like 'Tell me more about what you've been feeling' encourage the patient to elaborate and demonstrate active listening, which is the foundation of therapeutic communication. Option B is false reassurance, which minimizes the patient's feelings and is non-therapeutic. Option C gives unsolicited advice, shifting focus away from the patient's expressed feelings. Option A uses a 'why' question and a dismissive judgment, both of which are non-therapeutic communication techniques.
Question 2easy
A nurse is assessing a patient for suicide risk. Which action by the nurse is MOST appropriate when the patient hints at not wanting to live anymore?
- A.Immediately call the physician without speaking further with the patient
- B.Reassure the patient that suicidal thoughts are a normal part of life
- C.Avoid asking directly about suicide to prevent planting the idea
- D.Ask the patient directly, 'Are you thinking about suicide?'✓
Correct answer: D
Direct questioning about suicide — such as asking 'Are you thinking about suicide?' — is the standard of care and does not increase suicide risk. It opens communication and allows for accurate risk assessment. Option C is a common myth; asking directly does not plant the idea. Option A bypasses the nurse's responsibility to assess and communicate with the patient. Option B is false reassurance and minimizes the seriousness of suicidal ideation.
Question 3easy
A patient whose spouse died two weeks ago tells the nurse, 'I keep expecting my husband to walk through the door. I know he's gone, but it just doesn't feel real.' The nurse recognizes this response as which stage of Kübler-Ross's grief model?
- A.Denial✓
- B.Depression
- C.Anger
- D.Bargaining
Correct answer: A
The patient's statement that the death 'doesn't feel real' and the expectation that the deceased will return are hallmark signs of the denial stage of Kübler-Ross's grief model, in which the person has difficulty accepting the reality of the loss. Anger involves feelings of rage or resentment. Bargaining involves 'if only' or 'what if' statements in an attempt to regain control. Depression involves profound sadness and withdrawal. These stages are not linear and individuals may move between them.
Question 4easy
A nurse is caring for a patient admitted for alcohol use disorder who is 24 hours into withdrawal. The nurse should monitor the patient MOST closely for which life-threatening complication?
- A.Urinary retention and constipation
- B.Seizures and hallucinations (delirium tremens)✓
- C.Hypoglycemia and weight gain
- D.Bradycardia and hyponatremia
Correct answer: B
Delirium tremens (DTs) — characterized by severe autonomic instability, seizures, and hallucinations — is the most life-threatening complication of alcohol withdrawal, typically occurring 24–72 hours after the last drink. The CIWA scale is used to assess severity and guide treatment. Hypoglycemia can occur but is not the primary life-threatening concern, and weight gain is not associated with withdrawal. Bradycardia is incorrect; alcohol withdrawal causes tachycardia and hypertension. Urinary and bowel changes are not hallmark dangers of alcohol withdrawal.
Question 5easy
A nurse is caring for a patient who discloses experiencing domestic violence at home. Which response by the nurse BEST reflects a non-judgmental, therapeutic approach?
- A."Why do you stay with someone who hurts you?"
- B."You need to leave that relationship immediately for your own safety."
- C."I'm glad you told me. You are not alone, and I want to help keep you safe."✓
- D."Have you thought about what you did to make your partner act this way?"
Correct answer: C
Responding with 'I'm glad you told me. You are not alone, and I want to help keep you safe.' validates the patient's courage in disclosing, expresses support, and focuses on safety without placing blame — the cornerstone of a therapeutic, non-judgmental approach to domestic violence. Option B gives direct advice and pressures the patient, which can be harmful and drive them away from seeking help. Option A is a 'why' question that implies the patient is responsible for staying. Option D places blame on the victim, which is never appropriate and is non-therapeutic.
Question 6easy
A nurse is caring for a patient with schizophrenia who states, 'The television is sending me secret messages about my mission.' Which term BEST describes this patient's statement?
- A.Flight of ideas
- B.Confabulation
- C.Hallucination
- D.Delusion of reference✓
Correct answer: D
A delusion of reference is a false belief that external stimuli — such as a television broadcast — are specifically directed at or have special meaning for oneself. This is a classic positive symptom of schizophrenia. A hallucination is a false sensory perception without an external stimulus (e.g., hearing voices), not a false belief about an existing stimulus. Flight of ideas is a rapid, loosely connected flow of thoughts seen in mania. Confabulation is the unconscious fabrication of memories, typically associated with Korsakoff syndrome.
Question 7easy
A nurse is providing care to a patient who becomes overly dependent and begins calling the nurse 'just like my mother.' The nurse recognizes this as which therapeutic relationship concept?
- A.Transference✓
- B.Countertransference
- C.Rapport
- D.Empathy
Correct answer: A
Transference occurs when a patient unconsciously redirects feelings and attitudes from a significant person in their past — such as a parent — onto the nurse or therapist. This is a common phenomenon in therapeutic relationships that nurses must recognize and address professionally. Countertransference is the opposite: when the nurse projects feelings onto the patient. Empathy is the nurse's ability to understand and share the patient's feelings without losing objectivity. Rapport refers to a trusting, harmonious relationship between nurse and patient.
Question 8easy
A patient who has been drinking alcohol heavily for years is admitted to the hospital and reports feeling anxious, sweating, and having a mild tremor 12 hours after their last drink. The nurse recognizes these as early signs of alcohol withdrawal and anticipates using which tool to guide ongoing assessment?
- A.Brief Pain Inventory (BPI)
- B.Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale✓
- C.Confusion Assessment Method (CAM)
- D.Glasgow Coma Scale (GCS)
Correct answer: B
The CIWA scale is the standardized tool used to assess the severity of alcohol withdrawal symptoms, including tremor, diaphoresis, anxiety, agitation, nausea, and perceptual disturbances. Scores guide medication administration (typically benzodiazepines) to prevent progression to severe withdrawal, including delirium tremens (DTs) and seizures. The Glasgow Coma Scale assesses level of consciousness and is not specific to withdrawal. The Brief Pain Inventory measures pain severity and interference. The Confusion Assessment Method screens for delirium but does not guide alcohol withdrawal management.
Question 9easy
During a crisis intervention, the nurse's immediate priority is to ensure the patient's physical safety before addressing the emotional or psychological aspects of the crisis.
Correct answer: A
This statement is TRUE. In crisis intervention, immediate safety is always the first priority, consistent with the ABCs framework and Maslow's Hierarchy of Needs. Physical safety must be established before any therapeutic work addressing the emotional or psychological dimensions of the crisis can be effectively undertaken. Attempting to address emotional needs while the patient remains in physical danger is not appropriate nursing practice.
Question 10easy
Asking a patient 'Why did you stop taking your medication?' is considered a therapeutic communication technique because it encourages the patient to reflect on their behavior.
Correct answer: B
This statement is FALSE. 'Why' questions are considered non-therapeutic because they can make the patient feel defensive, judged, or interrogated. A more therapeutic approach would be to use an open-ended statement such as 'Tell me more about what happened with your medication.' Non-therapeutic communication patterns — including 'why' questions, false reassurance, giving unsolicited advice, and changing the subject — are known barriers to effective nurse-patient communication.