LVN Psychosocial Integrity 2 — Questions and Answers
Question 1: A patient with anxiety repeatedly says, 'I'm not really that anxious — I just had too much coffee.' Which defense mechanism is the patient using?
- Projection
- Rationalization (Correct answer)
- Repression
- Displacement
Correct answer: Rationalization
Rationalization involves creating logical-sounding excuses to justify anxiety-provoking feelings or behaviors.
Question 2: Which nursing response BEST demonstrates therapeutic communication when a patient states, 'I feel like no one understands me'?
- 'I understand exactly how you feel.'
- 'Tell me more about what you're experiencing.' (Correct answer)
- 'Everyone feels that way sometimes.'
- 'You should talk to your family about this.'
Correct answer: 'Tell me more about what you're experiencing.'
Open-ended prompts encourage the patient to elaborate and demonstrate the nurse's genuine interest.
Question 3: A patient with a new colostomy refuses to look at the stoma and says, 'I'm disgusting.' The nurse identifies this as which nursing diagnosis?
- Ineffective coping
- Social isolation
- Disturbed body image (Correct answer)
- Chronic low self-esteem
Correct answer: Disturbed body image
Disturbed body image is evidenced by refusal to look at the stoma and negative verbalization about altered appearance.
Question 4: When using the PHQ-9 tool, the LVN is screening a patient for:
- Generalized anxiety disorder
- Depression severity (Correct answer)
- Suicidal risk stratification
- Cognitive impairment
Correct answer: Depression severity
The PHQ-9 (Patient Health Questionnaire-9) is a validated tool used to screen for and measure the severity of depression.
Question 5: A patient with panic disorder begins hyperventilating in the hallway. The nurse's PRIORITY intervention is to:
- Administer PRN anxiolytic immediately
- Leave the patient alone in a quiet room
- Stay with the patient and speak in a calm, reassuring voice (Correct answer)
- Instruct the patient to breathe into a paper bag
Correct answer: Stay with the patient and speak in a calm, reassuring voice
Staying calm, providing presence, and using a reassuring tone helps reduce acute panic and prevents escalation.
Question 6: A patient tells the nurse, 'I can't do anything right.' Which response by the nurse is MOST therapeutic?
- 'Of course you can — don't say that.'
- 'What makes you feel that way?' (Correct answer)
- 'You'll feel better once your medication kicks in.'
- 'Lots of patients feel the same way at first.'
Correct answer: 'What makes you feel that way?'
Asking what makes the patient feel that way explores the underlying concern and validates their experience.
Question 7: Which behavior indicates a patient is maintaining appropriate therapeutic boundaries with the nurse?
- Asking the nurse to be their friend on social media
- Sharing personal problems with the nurse to get advice
- Discussing only care-related concerns during interactions (Correct answer)
- Offering the nurse a monetary gift as a thank-you
Correct answer: Discussing only care-related concerns during interactions
Therapeutic relationships remain focused on the patient's health needs; socializing, gifts, and personal advice fall outside professional boundaries.
LVN Psychosocial Integrity 2
A patient with anxiety repeatedly says, 'I'm not really that anxious — I just had too much coffee.' Which defense mechanism is the patient using?