NACE Psychosocial Needs and Development 4 — Questions and Answers
Question 1: A client with a new colostomy refuses to look at the stoma and says, 'I'm disgusting.' Which nursing diagnosis is the priority?
- Disturbed body image (Correct answer)
- Risk for infection
- Deficient knowledge
- Impaired skin integrity
Correct answer: Disturbed body image
Refusal to look at the stoma and negative self-statements indicate disturbed body image as the priority psychosocial diagnosis.
Question 2: According to Erikson, a 70-year-old who expresses regret about life choices and feels despair is experiencing failure of which developmental stage?
- Generativity vs. stagnation
- Ego integrity vs. despair (Correct answer)
- Intimacy vs. isolation
- Identity vs. role confusion
Correct answer: Ego integrity vs. despair
Ego integrity vs. despair is Erikson's stage for late adulthood (65+), where failure results in despair over an unfulfilling life.
Question 3: A nurse is caring for a client experiencing anticipatory grief. Which intervention is most therapeutic?
- Encourage the client to stay positive and avoid dwelling on loss
- Provide a quiet environment and allow the client to express feelings freely (Correct answer)
- Reassure the client that their fears may not come true
- Refer the client immediately to a psychiatrist
Correct answer: Provide a quiet environment and allow the client to express feelings freely
Allowing free expression of feelings in a supportive environment is the most therapeutic approach to anticipatory grief.
Question 4: A client states, 'My doctor says I have cancer, but I know the lab results are wrong.' This is an example of which defense mechanism?
- Rationalization
- Projection
- Denial (Correct answer)
- Displacement
Correct answer: Denial
Denial involves refusing to acknowledge a painful reality, such as rejecting a cancer diagnosis.
Question 5: Which behavior best demonstrates a client successfully resolving Erikson's stage of 'Industry vs. Inferiority'?
- A teenager forming a stable personal identity
- A school-age child completing projects and feeling competent (Correct answer)
- A toddler asserting independence during daily tasks
- An adult forming close personal relationships
Correct answer: A school-age child completing projects and feeling competent
Industry vs. Inferiority occurs during school age (6–12 years) and is resolved by developing a sense of competence through completing tasks.
Question 6: A nurse notices a client has been isolating herself and crying frequently since her husband's death two weeks ago. The nurse's best initial action is to:
- Administer a PRN anxiolytic as ordered
- Sit with the client and offer presence without pressure to talk (Correct answer)
- Document the behavior and notify the physician
- Encourage the client to join group therapy immediately
Correct answer: Sit with the client and offer presence without pressure to talk
Offering therapeutic presence acknowledges the client's grief and communicates support without imposing expectations.
Question 7: A client who recently lost a limb says, 'I know I'll never be normal again, but I'm learning to adapt.' This statement reflects which phase of Kübler-Ross's grief model?
- Bargaining
- Depression
- Acceptance (Correct answer)
- Anger
Correct answer: Acceptance
Acceptance is characterized by acknowledging the loss and beginning to adapt to a new reality.
NACE Psychosocial Needs and Development 4
A client with a new colostomy refuses to look at the stoma and says, 'I'm disgusting.' Which nursing diagnosis is the priority?