A nurse is admitting a client to an alcohol abuse program. The client states, "I'm here because of my boss.
It was part of my job to go to parties and drink with clients." The client's statement is an example of which of the following defense mechanisms?

Choice A rationale:

Manifestations of seizure activity are not a common adverse effect of clonazepam. In fact, clonazepam is often used to treat seizures. It is a benzodiazepine that works by decreasing abnormal electrical activity in the brain.

While it is possible for clonazepam to worsen seizures in some individuals, this is not a typical response. Therefore, it is not the most important adverse effect for the nurse to monitor.

Choice B rationale:

Decreased urine output is not a known adverse effect of clonazepam.

Some medications can affect kidney function and urine output, but clonazepam is not one of them. Therefore, it is not necessary for the nurse to monitor urine output in a client taking clonazepam. Choice C rationale:

Inability to recall events, also known as amnesia, is a common adverse effect of clonazepam.

Clonazepam can impair short-term memory, making it difficult for people to remember things that happened recently.

This can be a significant problem for clients who need to be able to recall important information, such as instructions from their healthcare providers.

Therefore, it is important for the nurse to monitor clients taking clonazepam for signs of amnesia.

Choice D rationale:

An increase in white blood cell count is not a known adverse effect of clonazepam. In fact, clonazepam can sometimes cause a decrease in white blood cell count.

However, this is a rare side effect and is not typically something that the nurse would need to monitor.

Choice A rationale: The statement “My arms often feel weak and spastic” does not indicate obsessive-compulsive disorder (OCD). This could be a symptom of a physical condition or a different mental health disorder, but it does not align with the common symptoms of OCD. OCD is characterized by unwanted, recurring thoughts and repetitive behaviors.

Choice B rationale: The statement “I check where my car keys are ten times” is indicative of OCD. One of the key symptoms of OCD is the need to check things repeatedly due to persistent, unwanted thoughts and fears. The individual may check something over and over again, such as whether the door is locked or where their car keys are, even if they know they’ve already checked. This behavior is a compulsion - an act the person feels compelled to perform to alleviate the distress caused by the obsessive thought.

Choice C rationale: The statement “I’m embarrassed to go out and speak in public” could be indicative of social anxiety disorder, not OCD. Social anxiety disorder is characterized by a fear of social situations and interactions, particularly those involving the possibility of scrutiny or judgment by others. While people with OCD can also have social anxiety disorder, embarrassment about going out and speaking in public is not a typical symptom of OCD12.

Choice D rationale: The statement “I keep reliving a car accident almost every day” is more indicative of post- traumatic stress disorder (PTSD) than OCD. PTSD is a mental health disorder that can develop after experiencing or witnessing a traumatic event, such as a car accident. Symptoms of PTSD include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. While people with OCD can have intrusive thoughts, these thoughts are typically related to themes like contamination or orderliness, rather than reliving past traumas.