NCLEX-RN psychosocial integrity syllabus
Psychosocial Integrity carries 6 to 12 per cent of the exam and it is the category where the right answer is most often a sentence rather than an action. Therapeutic communication questions ask what the nurse should say, and the options are built so that several sound kind while only one is therapeutic.
It is also where the exam tests how you respond to a client in crisis, in grief or behaving in ways that are difficult to manage. The NCLEX-RN syllabus hub page covers the other categories.
Pattern
| Element | Detail |
|---|---|
| Format | Computerised adaptive testing |
| Minimum items | 85 |
| Maximum items | 150 |
| Unscored pretest items | 15 on every exam, not identified |
| Maximum time | Five hours, including all breaks |
| Result | Pass or fail. No numerical score is reported |
| Passing standard | 0.00 logits |
| Negative marking | None |
An individual exam may differ from the published distributions by up to three percentage points in each category. The full distribution is below.
| Client Needs category or subcategory | Percentage range |
|---|---|
| Management of Care | 15 to 21% |
| Safety and Infection Prevention and Control | 10 to 16% |
| Health Promotion and Maintenance | 6 to 12% |
| Psychosocial Integrity | 6 to 12% |
| Basic Care and Comfort | 6 to 12% |
| Pharmacological and Parenteral Therapies | 13 to 19% |
| Reduction of Risk Potential | 9 to 15% |
| Physiological Adaptation | 11 to 17% |
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Psychosocial Integrity, 6 to 12 per cent
- Abuse and neglect
- Behavioural interventions
- Chemical and other dependencies, including substance use disorder
- Coping mechanisms
- Crisis intervention
- Cultural awareness and influences on health
- End of life care
- Family dynamics
- Grief and loss
- Mental health concepts
- Religious and spiritual influences on health
- Sensory and perceptual alterations
- Stress management
- Support systems
- Therapeutic communication
- Therapeutic environment
What is not in this category
- No psychiatric diagnosis. The exam tests nursing response rather than diagnosis
- No psychotropic medication detail, which sits under Pharmacological and Parenteral Therapies
- No physiological assessment
- No management or delegation content, which sits under Management of Care
How to spend the time
Learn the therapeutic communication patterns rather than individual scripts. Options that give advice, offer false reassurance, ask why, or change the subject are wrong by construction, and recognising those four removes most distractors before you weigh the rest.
Crisis intervention questions reward safety first. Where an option addresses immediate risk and another addresses feelings, the risk comes first.
Grief and end of life questions frequently test staying present rather than fixing. The option that acknowledges the feeling usually beats the option that solves the problem.
Cultural and spiritual influence questions test asking rather than assuming. The answer that elicits the client’s own preference is almost always right. Browse the available NCLEX-RN practice papers.
Common mistakes
- Choosing the kindest sounding option rather than the therapeutic one
- Offering reassurance, which closes a conversation the question wants opened
- Asking why in a therapeutic communication answer, which is rarely correct
- Assuming a cultural or religious preference rather than eliciting it
- Addressing feelings before immediate safety in a crisis question
- Preparing psychiatric diagnosis when the exam tests nursing response
Psychosocial Integrity against Physiological Integrity
| Feature | Psychosocial Integrity | Physiological Integrity |
|---|---|---|
| Percentage range | 6 to 12% | Four subcategories, 6 to 19% each |
| Typical answer | Something the nurse says | Something the nurse does |
| What is tested | Response to emotional and mental need | Response to physical need |
| Overlap | End of life care | Physiological adaptation at end of life |
Frequently asked questions
How much of the NCLEX-RN is Psychosocial Integrity?
6 to 12 per cent of the exam.
What is a therapeutic communication question?
One that asks what the nurse should say. The correct option keeps the conversation open and acknowledges the client, rather than advising or reassuring.
Is abuse and neglect covered?
Yes, named in the category alongside family dynamics and support systems.
Is substance use disorder tested?
Yes, under chemical and other dependencies.
Does this category cover end of life care?
Yes, alongside grief and loss.
Are psychiatric diagnoses tested?
The exam tests nursing response rather than diagnosis.
Where do psychotropic medications sit?
Under Pharmacological and Parenteral Therapies rather than here.
Is cultural awareness assessed?
Yes, with religious and spiritual influences on health. Questions reward eliciting the client’s preference rather than assuming it.
Did the percentage change in the current test plan?
No. The 6 to 12 per cent range is unchanged.
Why do several options sound right in this category?
Distractors are written to sound caring. Only one keeps the conversation open and addresses the client’s stated concern.