A 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism?

Projection

Repression

Denial

Regression

Answer and Explanation

The Correct Answer is D

A.   Projection involves attributing one’s own unacceptable feelings or thoughts onto another person. However, in this case, the patient’s tantrum and crying are more about their own inability to handle the refusal rather than projecting feelings onto others.
B.   Repression is a defense mechanism where distressing thoughts or feelings are unconsciously blocked from entering awareness. For instance, if the patient were to push aside their feelings of disappointment about not receiving the diet pills without expressing them, that would be repression.
C.   Denial involves refusing to accept reality or facts that are distressing or threatening. However, the primary behavior in this situation is the tantrum and crying, which are more indicative of another defense mechanism rather than outright denial.
D.   Regression is a defense mechanism where an individual reverts to behaviors characteristic of an
earlier developmental stage in response to stress or conflict. The patient’s crying and tantrum can be seen as regressive behavior because it reflects a return to more childlike or immature ways of handling frustration, similar to how a child might react to not getting what they want.

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Correct Answer is B

Explanation

A. Depression is characterized by persistent feelings of sadness, loss of interest or pleasure in activities, changes in sleep and appetite, and difficulties with daily functioning. However, depression alone might not fully explain the abrupt change if there were no prior context of mood swings or manic behavior.
B. Bipolar disorder is marked by extreme mood swings that include manic or hypomanic episodes and depressive episodes. The observed behaviors—active participation and high energy followed by a
sudden shift to tearfulness and withdrawal—are consistent with the mood cycling seen in bipolar disorder. The manic or hypomanic phase could explain the previous high level of activity, while the depressive phase explains the sudden refusal to engage and withdrawal.
C. Psychotic behavior involves a loss of touch with reality, including hallucinations, delusions, and disorganized thinking. The behaviors described (active participation and then sudden withdrawal) do not specifically indicate psychosis.
D. Dysthymic disorder (now referred to as Persistent Depressive Disorder in the DSM-5) is characterized by a chronic, mild depression lasting for at least two years. It typically involves a more consistent, persistent low mood rather than the abrupt shifts seen in bipolar disorder.

A. It's okay to skip the session but the others will get ideas. B. will just stay with you for a while. C. You don't feel like attending the group therapy today?" D. Why don't you want to attend group therapy?"

Correct Answer is C

Explanation

A. This response is dismissive and doesn't address the client's feelings. It also implies that the client's absence will negatively impact the group, which is not helpful.
B. While this shows empathy, it doesn't address the client's reason for not wanting to attend the group.
C. This response acknowledges the client's feelings without being judgmental and opens a space for further communication.
D. This question might put the client on the defensive and can be perceived as challenging. It's important to create a safe and supportive environment for the client to express their feelings.

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A 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A client who usually is very active in her therapy group tells the nurse that she really does "not feel well today" and would "rather not attend the group therapy session. Which is the nurse's most appropriate response?

Correct Answer is C

Explanation

Which client would be a candidate for Electroconvulsive Therapy (ECT)?

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