Psychosocial Integrity NCLEX-RN Test Bank 220 Questions with Answers and Rationale; Graded A+
A nurse is caring for a client with bipolar disorder. The nurse reads in the client’s
medical record that the client was awake the previous night experiencing an
acute manic episode. Which of the fo...
Psychosocial Integrity NCLEX-RN Test Bank 220
Questions with Answers and Rationale; Graded A+
Psychosocial Integrity Drill 1
Question 1
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A nurse is caring for a client with bipolar disorder. The nurse reads in the client’s
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medical record that the client was awake the previous night experiencing an
acute manic episode. Which of the following interventions should the nurse
include when planning care for this client?
A
Offer a warm shower before bedtime
B
Limit visitors during the day
C
Provide frequent rest periods during the daytime Correct Answer (Blank)
D
Encourage stimulating activities throughout the day
Question Explanation
Rationale: A client who is experiencing an acute manic episode will exhibit restlessness,
going from activity to activity with heightened emotional response. A client who was
awake all night from a manic episode will need rest periods throughout the day.
Encouraging stimulating activities can exacerbate the manic episode. While a warm
shower before bed could be relaxing, it will not prevent the client from experiencing
insomnia from the manic episode. Limiting visitors could decrease simulation but does
not impact the effects of the manic episode.
Concepts tested
NCLEX: Psychosocial Integrity
Question 2
The nurse is planning care for a client with bipolar who is experiencing an acute
manic episode. Which action is a priority for the nurse to implement?
A
Encourage the client to perform hygiene care
B
Advise the client to participate in group therapy
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C
Instruct the client to drink fluids every hour Correct Answer (Blank)
D
Tell the client to report when symptoms get worse
Question Explanation
Rationale: When caring for a client with bipolar who is experiencing an acute episode,
the priority actions for the nurse are to keep the client safe and prevent injury. During
an acute manic episode, the client will have extreme restlessness and physical activity
may be difficult to control. The nurse should implement actions to keep the client
hydrated, rested, and safe. The client in the acute manic episode will not have the
cognitive focus to attend group therapy, perform hygiene care, and report changes in
condition.
Concepts tested
NCLEX: Psychosocial Integrity
Question 3
The clinic nurse is interviewing a client who is being evaluated for psychiatric
care. Which statement by the client would support a diagnosis of a manic
episode of bipolar disorder?
A
“I often need to take several naps during the day.”
B
“I noticed that I have been eating more at night while watching television.”
C
“I plan on quitting my job so I can devote more time to social media.” Correct
Answer (Blank)
D
"I have skipped going to the gym for the past week.”
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Question Explanation
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Rationale: Bipolar disorder is a group of disorders that has cycles of depression and
irritable or erratic moods. When a client is experiencing a manic episode of bipolar
disorder, the client will have an intense mood, where the client may make irrational
choices, such as quitting a job. The client may have grandiose ideas of becoming famous.
A client who reports sleeping more often, increasing eating, or skipping routine
activities may be experiencing depression.
Concepts tested
NCLEX: Psychosocial Integrity
Question 4
The nurse is assessing a client who has a history of anxiety. The client states, “I
always think I leave the stove on; I must have obsessive-compulsive disorder.”
Which statement would be appropriate for the nurse to make?
A
"Are there any triggers to this feeling?”
B
“Can you describe how you feel when you have that thought?” Correct Answer
(Blank)
C
"Do you worry about other things?”
D
“Does it happen every day?”
Question Explanation
Rationale: Obsessive-compulsive disorder is a neurological disorder where the client
experiences intrusive thoughts (obsessions) and ritualistic behaviors (compulsive). The
client will report having a recurring thought, such as leaving the stove on. The thought is
persistent, and the client cannot focus on anything else. The nurse should ask the client
to describe how they feel when experiencing the intrusive thought. With OCD, there is
no distinct trigger to the intrusive thought. Asking if the client worries about other
things does not assess how the thought is processed by the client. Often with OCD, the
intrusive thoughts are ongoing, without any time constraints.
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