NCLEX-RN, Medical exams, 6–12%

Psychosocial Integrity

Promoting emotional, mental, and social well-being: therapeutic communication, crisis intervention, abuse and neglect, substance use, grief, and care of clients with mental health conditions.

Position: 4 of 8 client needs categories
Published weighting: 6–12% in the official framework
Topics covered: 5 topics in this guide

What is covered

Topics inside this client needs category.

These topics describe the scope students most often review for this part of NCLEX-RN. Treat them as a study checklist rather than an exhaustive list of what a single exam form can sample.

Therapeutic communication: Open-ended questions, reflection, and the responses that block communication.
Crisis intervention and suicide risk: Direct questions about suicide, safety plans, and environmental precautions.
Abuse, neglect, and violence: Recognizing signs of abuse, mandatory reporting, and safety planning.
Substance use and withdrawal: Alcohol withdrawal timing and assessment, and the withdrawal patterns of common substances.
Grief, loss, and end of life: Stages of grief, cultural practices at death, and supporting families.

Study tips

How to practice Psychosocial.

Section-specific guidance that follows from how this material is usually tested.

Choose answers that acknowledge the client's feelings and invite them to say more.
When a client hints at self-harm, the next step is to ask directly about suicide.
Pair each mental health condition with its safety priority.

Where this fits

Psychosocial Integrity is 4 of 8 client needs categories in the NCLEX-RN guide, and it carries a published weighting of 6–12% in the official framework. Use the full guide to balance it against everything else you have to review.

Back to the NCLEX-RN guide Official exam information

Sample Psychosocial questions

Practice questions, not yet expert-reviewed

Original practice questions written to the published framework for this section. No expert has reviewed them, and they are not taken from any official exam. Try each one before you open the answer.

Question 1Foundational
Which response by the nurse is an example of therapeutic communication with a client who says, "I feel like nothing will ever get better"?
1. A"You should think about the positive things in your life."
2. B"Tell me more about what is making you feel this way."
3. C"Don't worry, everything will be fine."
4. D"Why do you feel that way?"
Show answer
Answer: B. "Tell me more about what is making you feel this way."
An open-ended invitation to say more is therapeutic. False reassurance, asking why, and giving advice block communication and can make the client feel judged.
Key insight: Invite the client to say more; avoid reassurance, why questions, and advice.
Question 2Intermediate
A client says, "My family would be better off without me." What should the nurse do first?
1. AAsk the client directly whether they are thinking of suicide
2. BChange the subject to something more positive
3. CTell the client that their family loves them
4. DDocument the statement and check on the client later
Show answer
Answer: A. Ask the client directly whether they are thinking of suicide
A statement like this may hint at suicidal thoughts. Asking directly does not plant the idea; it opens the conversation and lets the nurse assess risk and keep the client safe.
Key insight: Ask directly about suicide when a client hints at it.
Question 3Intermediate
When do symptoms of alcohol withdrawal usually begin after the last drink?
1. A1 to 2 hours
2. B3 to 4 days
3. C1 to 2 weeks
4. D6 to 24 hours
Show answer
Answer: D. 6 to 24 hours
Withdrawal symptoms such as tremors, anxiety, and tachycardia usually begin 6 to 24 hours after the last drink. Delirium tremens, the most severe form, typically appears 48 to 72 hours after.
Key insight: Alcohol withdrawal begins within a day; delirium tremens peaks around days 2 to 3.
Question 4Foundational
Which finding in a child should make the nurse suspect physical abuse?
1. AA bruise on the shin of a toddler who is learning to walk
2. BA small burn on one fingertip after touching a stove
3. CBruises in different stages of healing on the back and buttocks
4. DA scraped knee after a fall from a bicycle
Show answer
Answer: C. Bruises in different stages of healing on the back and buttocks
Bruises of different ages in protected areas such as the back and buttocks suggest repeated inflicted injury. Bruises on the shins and knees and small burns on fingertips are common accidental injuries.
Key insight: Injuries of different ages in protected areas suggest abuse.
Question 5Advanced
A client receiving a diagnosis of terminal cancer says, "The tests must be wrong." Which stage of grief does this statement show?
1. AAcceptance
2. BDenial
3. CAnger
4. DBargaining
Show answer
Answer: B. Denial
Refusing to believe the news is denial, the first stage in the Kübler-Ross model. Anger directs blame, bargaining tries to make a deal to delay the outcome, and acceptance comes to terms with it.
Key insight: Disbelief at bad news is denial.

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Psychosocial Integrity