NCLEX-PN practice test

NCLEX-PN Psychosocial Integrity Practice Test

Therapeutic communication, coping, abuse, substance use, grief and end of life. Here are 8 NCLEX-PN psychosocial integrity questions, each with the answer and the reason.

Updated 2026-11-14 by the Tigertest team. Based on the NCSBN 2026 NCLEX-PN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.

1. 1.

   A client in a manic phase of bipolar disorder is talking rapidly, has not slept in 2 days and is not eating. Which action by the PN is most helpful?

   • A.

     Encourage the client to join the group activity

   • B.

     Ask the client to sit down for a full meal

   • C.

     Offer finger foods to eat on the move

   • D.

     Explain that the behavior disturbs the other clients

   Answer: C.

   A client in mania cannot sit still long enough for a meal, so high-calorie finger foods and fluids offered while moving keep nutrition up. Group activities add stimulation, and confronting the behavior increases agitation.

2. 2.

   A client who has just learned of a cancer diagnosis says to the PN, "Why did this happen to me?" Which response is therapeutic?

   • A.

     "This must be very hard to take in."

   • B.

     "Everything happens for a reason."

   • C.

     "The doctors here are the best."

   • D.

     "Try not to think about it right now."

   Answer: A.

   Reflecting the client's feelings invites the client to keep talking. Cliches, false reassurance and telling the client not to think about it all shut the conversation down.

3. 3.

   A resident whose spouse died 1 month ago cries during care and says, "I keep expecting him to call." How should the PN interpret this?

   • A.

     A sign of complicated grief

   • B.

     An expected grief response

   • C.

     A symptom of major depression

   • D.

     The start of dementia

   Answer: B.

   Crying, yearning and momentarily expecting the person to still be there are normal in the first months after a loss. Grief is considered complicated when intense symptoms persist for a year or more or stop the person from functioning.

4. 4.

   A resident with dementia becomes agitated every evening and insists on "going home to make dinner." Which approach should the PN use?

   • A.

     Remind the resident that this is her home now

   • B.

     Explain that her house was sold years ago

   • C.

     Offer a simple task such as folding towels

   • D.

     Ask the resident why she wants to leave

   Answer: C.

   Redirecting to a familiar, purposeful activity calms a resident with dementia without arguing about facts she cannot retain. Reality orientation and explanations about the sold house increase distress, and asking why requires reasoning the resident no longer has.

5. 5.

   At a clinic, the PN notices bruises in different stages of healing on a 6-year-old's back. The parent says the child "falls a lot." What should the PN do?

   • A.

     Ask the parent to explain each bruise

   • B.

     Accept the explanation and document it

   • C.

     Confront the parent about abuse

   • D.

     Report suspected abuse per state law

   Answer: D.

   Nurses are mandated reporters, so suspected child abuse is reported to the RN and provider and to the child protective agency according to state law; proof is not required. Confronting the parent can put the child at greater risk, and accepting an explanation that does not fit the injuries fails the child.

6. 6.

   A client scheduled for surgery in an hour is pacing, has trembling hands and says, "I can't stop thinking about it." Which action should the PN take first?

   • A.

     Stay with the client and speak calmly

   • B.

     Ask the client to describe the surgery

   • C.

     Give the preoperative sedative early

   • D.

     Leave the client alone to calm down

   Answer: A.

   A calm presence lowers anxiety and lets the PN find out what the client is worried about. Asking for details of the surgery can increase fear, medications are given as prescribed, and leaving an anxious client alone increases distress.

7. 7.

   A client with a new colostomy refuses to look at the stoma and says, "There's nothing wrong with me. The surgery was a mistake." The PN recognizes this as which coping mechanism?

   • A.

     Projection

   • B.

     Denial

   • C.

     Regression

   • D.

     Rationalization

   Answer: B.

   Refusing to accept that the illness and surgery were real is denial, a common early response to a change in body image. Projection blames others for one's own feelings, regression is a return to earlier behavior, and rationalization invents acceptable reasons.

8. 8.

   A hospitalized client from a culture different from the PN's does not make eye contact during teaching. How should the PN interpret this?

   • A.

     A lack of interest in the teaching

   • B.

     Confirmation that the client is depressed

   • C.

     A possible sign of respect

   • D.

     A sign that the client does not understand

   Answer: C.

   In many cultures avoiding direct eye contact with a caregiver is a sign of respect, so the PN continues the teaching and checks understanding by asking the client to repeat it. Reading the behavior as disinterest, depression or confusion assumes the PN's own cultural norms.