A mental health nurse is caring for a client who smokes and has lung cancer.
The client reports, "I'm coughing because I have that cold everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms?

Reaction formation

Denial

Suppression

Regression.

Answer and Explanation

The Correct Answer is B

While the client's statement might seem like other defense mechanisms, here's why Denial is the most fitting choice: Denial:

Involves refusing to acknowledge a painful or threatening reality.

The client attributes their cough, a potential symptom of lung cancer, to a common cold, dismissing the possibility of their condition worsening.

This allows them to avoid the emotional distress associated with facing their illness. Other options and their rationales:

Reaction formation (Choice A): This involves expressing the opposite of what one truly feels or desires. The client doesn't show any outward signs of expressing emotions opposite to their actual feelings about their health.

Suppression (Choice C): This involves consciously pushing unpleasant thoughts or feelings out of awareness. While the client might downplay the cough, they haven't completely pushed the thought of their illness away.

Regression (Choice D): This involves reverting to an earlier stage of development in response to stress. There's no indication of the client displaying behaviors characteristic of an earlier developmental stage.

Addressing other potential mechanisms:

Displacement: Redirecting emotions towards a less threatening target is not evident in the scenario.

Rationalization: Justifying behavior in a way that avoids facing the true reasons is not seen in the client's explanation. Projection: Attributing one's own feelings or desires to others is not present in the client's statement.

Remember:

Denial is a common coping mechanism for dealing with difficult realities like illness.

It's crucial for the nurse to assess the extent of the client's denial and offer support without judgment.

The goal is to help the client acknowledge their illness while providing emotional support and resources for managing their condition.

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Correct Answer is C

Explanation

Choice A rationale:

This response indicates anger, not denial. The client is expressing anger towards the doctor and their perceived lack of competence. While anger can be a component of the grief process, it does not specifically align with the denial phase, which is characterized by a refusal to accept the reality of a situation.

Choice B rationale:

This response indicates fatigue or depression, not denial. The client is acknowledging their physical and emotional state but is not expressing disbelief or refusal to accept their diagnosis.

Choice C rationale:

This response clearly demonstrates denial. The client is minimizing the severity of their diagnosis and attributing the doctor's statements to an ulterior motive. This is a classic example of denial, as it involves a distortion of reality to avoid facing a painful truth.

Choice D rationale:

This response indicates acceptance, not denial. The client is acknowledging the reality of their situation and expressing gratitude for the care they have received.

A. "Why do you think you might have cancer when your diagnosis is a benign condition?" B. "I'm hearing that you are concerned that it might turn out that you have cancer." C. "I'm looking at your chart here and I don't see any reason for you to worry about that." D. "I think that's something you need to discuss with your provider.".

Correct Answer is B

Explanation

Choice A rationale:

This response is dismissive of the client's concerns and does not acknowledge their feelings. It also implies that the client is not knowledgeable about their own condition. This could make the client feel defensive and less likely to share their concerns in the future.

It focuses on the medical facts of the diagnosis rather than addressing the client's emotional state. It may come across as patronizing or judgmental, further alienating the client.

Choice B rationale:

This response demonstrates active listening and empathy. It acknowledges the client's feelings and validates their concerns. This can help to build trust and rapport with the client.

It encourages the client to express their fears and worries, which can be therapeutic in itself.

It opens the door for further discussion about the client's concerns and provides an opportunity for the nurse to offer support and education.

Choice C rationale:

This response is reassuring, but it does not address the client's underlying concerns. It may also come across as dismissive or patronizing.

It relies solely on the medical chart to make a judgment about the client's concerns, without taking into account the client's own perspective.

It does not provide an opportunity for the client to express their fears and worries.

Choice D rationale:

This response is a deflection and does not provide the client with the support they need in the moment. It may also make the client feel like their concerns are not being taken seriously.

It shifts the responsibility for addressing the client's concerns to the provider, which may not be helpful if the client is already feeling anxious or uncertain.

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A mental health nurse is caring for a client who smokes and has lung cancer.The client reports, "I'm coughing because I have that cold everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms?

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A mental health nurse is caring for a client who smokes and has lung cancer.
The client reports, "I'm coughing because I have that cold everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms?