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WorksheetsNCLEX-PN Domain 3 & 4
Total questions: 20
Worksheet time: 10mins
Reality orientation
Use clocks and calendars
Encourage isolation and silence
Argue with delusions to clarify reality
Ignore the patient's concerns
Substance use disorder
Tolerance and withdrawal
Loss of control
Use non-judgmental language
Continued use despite harm
Anxiety interventions
Teaching and coping strategies for mild/moderate anxiety
Encouraging the client to isolate themselves
Providing complex instructions
Using loud noises to distract the client
Defense mechanisms
Denial: refusal to accept reality
Projection: blaming others
Childlike behavior: Regression
Making excuses: Rationalization
Health promotion and psychosocial care – core focus
Promoting wellness and prevention
Maximizing treatment costs
Minimizing patient interaction
Focusing solely on physical health
Adolescent development
Identity vs role confusion
Increased dependence on parents
Decreased peer influence
Reduced risk-taking behaviors
Immunization principles
Mild illness is not a contraindication
Live vaccines are safe during pregnancy
Fever and soreness are rare side effects
Live vaccines contraindicated in pregnancy/immunocompromised
Preventive health care
Immunizations
Routine screenings
Health education
Emergency surgeries
Hallucinations vs delusions
Hallucination: false fixed belief
Delusion: false sensory perception
Hallucination: false sensory perception
Delusion: acknowledge feelings, not the belief
Therapeutic communication
• Use open-ended questions
• Focus on feelings
• Encourage expression
• Provide detailed instructions
Postpartum assessment
• Fundus firm and midline
• Lochia progression: rubra → serosa → alba
• Monitor for hemorrhage and infection
• Support bonding and breastfeeding
Mandatory reporting
Nurses are mandated reporters
Nurses must investigate all reports of abuse
Nurses can choose whether to report suspected abuse
Nurses should document their personal opinions
NCLEX-PN priority rule
Safety always comes first
Comfort is the highest priority
Treatment is more important than prevention
Risk of harm overrides comfort
Crisis intervention
Focus on immediate safety
Long-term therapy
In-depth psychological analysis
Encourage isolation from support systems
Effective health teaching
Use complex medical terminology
Avoid using written materials
Use teach-back method
Rely solely on verbal communication
Expected vs unexpected findings
Loss of previously learned skills
Developmental milestones achieved on time
Age-appropriate behavior
Developmental delays
Normal pregnancy changes
Increased heart rate
Decreased blood volume
Morning sickness in second trimester
Increased muscle cramps
Levels of anxiety
• Mild: alert, focused
• Severe: poor problem-solving
• Panic: loss of control
• Moderate: narrowed attention
Stress and coping
Coping is the same for everyone
Maladaptive coping decreases risk
Encourage healthy coping strategies
Coping is not important
Non-therapeutic communication
Giving advice
Providing emotional support
Changing the subject
Asking open-ended questions
