The NCLEX-RN exam is organized according to the framework, "Meeting Client Needs." There are four major categories:
- Safe and Effective Care Environment
- Health Promotion and Maintenance
- Psychosocial Integrity
- Physiological Integrity
Learn about Psychosocial Integrity below.
Psychosocial Integrity
Psychosocial Integrity accounts for 6-12 percent of the questions on the NCLEX-RN® exam. The nursing actions included in this subcategory are:
| Coping mechanisms | Counseling techniques |
| Grief and loss | Mental health concepts |
| Religious/spiritual influences on health Sensory/perceptual alterations | Situational role changes |
| Stress management | Therapeutic interactions |
| Support systems | Unexpected body image changes |
| Chemical dependency | Behavioral interventions |
| Child abuse/neglect | Domestic violence |
| Psychopathology | Therapeutic milieu |
| Crisis intervention | Elder abuse/neglect |
| Sexual abuse |
Typical Questions
The following is an example of a typical psychosocial integrity question:A 50-year old male patient comes to the nurse's station and asks the nurse if he can go to the cafeteria to get something to eat. When told that his privileges do not include visiting the cafeteria, the patient becomes verbally abusive. Which of the following approaches by the nurse would be most effective?
- Tell the patient to lower his voice because he is disturbing the other patients.
- Ask the patient what he wants from the cafeteria and have it delivered to his room.
- Calmly but firmly escort the patient back to his room.
- Assign a nursing assistant to accompany the patient to the cafeteria.
The correct answer is (3). The nurse should not reinforce abusive behavior. Patients need consistent and clearly defined expectations and limits.
The following is another example of a typical psychosocial integrity question:
The nurse in a well-child clinic assesses a 4-year old girl and observes multiple bruises on her back and buttocks. The parents state they don't know how the girl sustained the injury. It is most important for the nurse to:
- confront the parents about the suspected abuse.
- report the suspected abuse to the appropriate authority.
- refer the family to social services for counseling to prevent abuse.
document suspicions about the abuse in the medical record.
The correct answer is (2). According to law, all suspected cases of child abuse must be reported to the appropriate agency or authority. It is not sufficient to just document the suspected abuse in the medical record.