A client recently diagnosed with cancer continues to miss follow-up appointments and states, "The doctors must have made a mistake—there’s no way I’m that sick." According to Freud’s psychoanalytic theory, which defense mechanism is the client most likely using?

Rationalization

Regression

Denial

Projection

Answer and Explanation

The Correct Answer is C

Choice A reason: Rationalization involves creating logical explanations to justify behavior or feelings. In this case, the client is not justifying but outright rejecting the diagnosis, so this does not apply.

Choice B reason: Regression occurs when an individual reverts to earlier developmental behaviors, such as childish actions, to cope with stress. The client is not reverting to earlier behaviors but refusing to accept reality.

Choice C reason: Denial is the refusal to accept reality or facts, blocking external events from conscious awareness. The client’s insistence that the diagnosis is a mistake demonstrates denial, making this the correct defense mechanism.

Choice D reason: Projection occurs when a person attributes their unacceptable thoughts or feelings to someone else. The client is not attributing their illness to others but rejecting its existence altogether.

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Correct Answer is D

Explanation

Choice A reason: This response is factual but does not promote engagement or address the client’s passive stance. It emphasizes the nurse’s role without encouraging participation or collaboration from the older adult.

Choice B reason: This statement makes an assumption about the client’s feelings, labeling them as “angry,” which may not be accurate. It risks creating defensiveness and does not foster open communication or trust within the group.

Choice C reason: This response inappropriately offers group leadership to a member without assessing readiness or interest. It minimizes the therapeutic structure of the group and could confuse roles, making the group less effective.

Choice D reason: This option balances the acknowledgment of the nurse’s leadership role with an invitation for the client to share personal goals. It encourages involvement, respects autonomy, and helps build a therapeutic alliance by showing interest in what the older adult wants to accomplish.

A. Provide consistent structured rules and set firm limits on behavior. B. Use sympathy and reassurance to reduce the client’s resistance to authority. C. Allow the client flexibility in decision-making to encourage independence and self-direction. D. Develop a close, personal rapport with the client to build trust and encourage emotional expression.

Correct Answer is A

Explanation

Choice A reason: Consistent rules and firm boundaries are essential when working with individuals who display antisocial traits. Structure minimizes opportunities for manipulation and helps maintain safety and fairness on the unit.

Choice B reason: Offering sympathy and reassurance may reinforce manipulative behavior and undermine professional boundaries. It does not address the core issue of rule violation and lack of accountability.

Choice C reason: Allowing too much flexibility may increase opportunities for the client to exploit staff and disregard rules. This approach is counterproductive when dealing with manipulative behaviors.

Choice D reason: Developing a close, personal rapport risks blurring professional boundaries. Clients with these traits may exploit such relationships to gain privileges, which can disrupt treatment and unit structure.

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A client recently diagnosed with cancer continues to miss follow-up appointments and states, "The doctors must have made a mistake—there’s no way I’m that sick." According to Freud’s psychoanalytic theory, which defense mechanism is the client most likely using?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

At the first meeting of a group at a daycare center for older adults, the nurse asks one of the members what kinds of things the client would like to do with the group. The older adult shrugs and says, "You tell me. You're the leader." What would be the best response for the nurse to make?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

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