National Council Licensure Examination for Registered Nurses (NCLEX-RN) Psychosocial Integrity Syllabus

Psychosocial Integrity syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Psychosocial Integrity in National Council Licensure Examination for Registered Nurses (NCLEX-RN), not a summary of it.

1. 1

   Coping, Adaptation, and Crisis

   4 topics

   • Coping mechanisms and defense mechanisms
     • Adaptive versus maladaptive coping
     • Ego defense mechanisms
   • Crisis intervention and situational support
     • Stages of crisis and intervention strategies
   • Grief, loss, and end-of-life care
     • Kübler-Ross stages and anticipatory grief
     • Palliative and hospice care principles
   • Stress management and support systems
2. 2

   Mental Health Conditions and Therapeutic Care

   5 topics

   • Mood and anxiety disorders
     • Major depression, bipolar disorder, and suicide risk
     • Generalized anxiety, panic, OCD, and PTSD
   • Psychotic disorders
     • Schizophrenia, positive and negative symptoms
     • Managing hallucinations and delusions
   • Cognitive and neurocognitive disorders
     • Delirium versus dementia
   • Personality and eating disorders
   • Therapeutic communication and milieu therapy
     • Therapeutic versus nontherapeutic techniques
     • Therapeutic environment management
3. 3

   Behavioral, Chemical, and Abuse-Related Care

   4 topics

   • Substance use and dependence
     • Intoxication, withdrawal, and detoxification
     • Alcohol withdrawal and CIWA monitoring
   • Behavioral management and de-escalation
     • Managing aggression and violent behavior
   • Abuse, neglect, and violence
     • Recognizing abuse across the lifespan
     • Mandatory reporting and safety planning
   • Cultural, spiritual, and religious influences on care

Psychosocial Integrity flashcards for National Council Licensure Examination for Registered Nurses (NCLEX-RN)

18 of 51 cards from the Psychosocial Integrity deck — real questions with worked answers.

1. What is the difference between a coping mechanism and a defense mechanism?

   Coping mechanisms are conscious, deliberate efforts to manage stress (e.g., exercise, problem-solving); defense mechanisms are unconscious mental processes that protect the ego from anxiety (e.g., denial, projection).

2. Define the defense mechanism 'projection' and give an example.

   Attributing one's own unacceptable feelings or impulses to another person. Example: An angry client accuses the nurse of being angry at them.

3. What defense mechanism is 'displacement,' and how does it differ from 'projection'?

   Displacement is transferring emotions from a threatening target to a safer one (e.g., yelling at a child after being scolded by a boss). Unlike projection, the feeling is owned but redirected, not denied and assigned to someone else.

4. Distinguish 'repression' from 'suppression.'

   Repression is the unconscious, involuntary blocking of distressing thoughts from awareness; suppression is the conscious, voluntary act of putting a thought out of mind.

5. What defense mechanism is operating when a client channels unacceptable impulses into socially acceptable activities (e.g., aggression into sports)?

   Sublimation - considered the most mature/adaptive defense mechanism.

6. Define 'reaction formation' as a defense mechanism.

   Acting in a manner opposite to one's true unacceptable feelings (e.g., being overly kind to someone you actually dislike).

7. What is 'regression' as a defense mechanism?

   Retreating to behaviors characteristic of an earlier developmental stage to cope with stress (e.g., a hospitalized child reverting to bedwetting or thumb-sucking).

8. Define 'rationalization' and 'intellectualization.'

   Rationalization: offering logical-sounding excuses to justify unacceptable behavior. Intellectualization: using excessive reasoning/focus on facts to avoid the emotional impact of a situation.

9. What are the four phases of crisis according to Caplan's model of crisis development?

   Phase 1: anxiety rises, usual coping used. Phase 2: coping fails, anxiety increases. Phase 3: new resources/problem-solving mobilized. Phase 4: if unresolved, tension escalates to severe anxiety, panic, or psychological breakdown.

10. What is the primary goal of crisis intervention?

    To return the client to their pre-crisis level of functioning (baseline), not to cure or restructure personality. It is short-term and present-focused.

11. Name the three types of crises in mental health.

    Maturational (developmental, e.g., marriage, retirement), Situational (external events, e.g., job loss, illness), and Adventitious (unexpected disaster, e.g., natural disaster, violent crime).

12. How long does a crisis state typically last, and why is timing important?

    A crisis is usually self-limiting, lasting about 4-6 weeks. Timely intervention during this window is critical because the person is most receptive to help.

13. What is the nurse's priority focus during crisis intervention?

    Ensuring safety first, then using a directive, problem-focused approach centered on the immediate problem and available support/resources.

14. List the five stages of grief described by Kubler-Ross.

    Denial, Anger, Bargaining, Depression, and Acceptance (note: stages are not linear and may not all occur).

15. Differentiate anticipatory grief, complicated (dysfunctional) grief, and disenfranchised grief.

    Anticipatory: grieving before an expected loss. Complicated: prolonged, unresolved grief impairing function. Disenfranchised: grief that cannot be openly acknowledged or socially supported (e.g., loss of an ex-spouse, pet, or stigmatized loss).

16. What are the priorities of end-of-life palliative/hospice care?

    Comfort and quality of life rather than cure - including pain/symptom management, dignity, emotional and spiritual support, and family involvement.

17. What is the most therapeutic nursing response to a grieving or dying client expressing emotion?

    Use silence, active listening, and presence; acknowledge feelings (e.g., 'This must be very difficult for you') rather than offering false reassurance or changing the subject.

18. Differentiate eustress from distress.

    Eustress is positive, motivating stress that enhances performance; distress is negative stress that impairs functioning and can harm health.

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