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?
Suppression.
Rationalization.
Reaction-formation.
Compensation.
The Correct Answer is B
Choice A rationale:
Suppression involves the conscious, intentional effort to push unwanted thoughts, feelings, or memories out of awareness. It is not evident in the client's statement, as they are not actively trying to forget or avoid their alcohol use. Instead, they are attempting to justify it.
Choice B Rationale:
Rationalization is the defense mechanism most clearly demonstrated in the client's statement. It involves creating false but seemingly logical reasons to justify unacceptable behavior or feelings. The client is attributing their alcohol use to external factors (their boss and job requirements) rather than taking responsibility for their own choices and actions. This allows them to avoid confronting the reality of their addiction and the need for change.
Key characteristics of rationalization that align with the client's statement:
Externalizing blame: The client places responsibility for their drinking on their boss and job, rather than acknowledging their own agency.
Minimizing the problem: The client suggests that their drinking was merely a necessary part of their job, downplaying the extent of their alcohol use and its negative consequences.
Avoiding negative emotions: By shifting blame, the client protects themselves from feelings of guilt, shame, and responsibility associated with their addiction.
Choice C Rationale:
Reaction formation involves behaving in a way that is opposite to one's true feelings or impulses. This is not evident in the client's statement, as they are not expressing overly negative or critical attitudes towards alcohol. Instead, they are attempting to justify their use of it.
Choice D Rationale:
Compensation involves overemphasizing a desirable trait or behavior to make up for a perceived weakness or deficiency. This is not evident in the client's statement, as they are not highlighting any positive qualities or accomplishments to offset their alcohol use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
1. Understanding OCD:
OCD is a chronic mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
Individuals with OCD feel compelled to perform rituals to relieve anxiety or prevent perceived harm, even if they recognize the behaviors as excessive or irrational.
Rituals can consume significant time and interfere with daily functioning.
2. Rationale for Choice A:
Acknowledges the client's needs: Planning for rituals demonstrates understanding and acceptance of the client's experience, fostering trust and rapport.
Reduces anxiety: Allowing time for rituals can temporarily reduce anxiety, making the client more receptive to other interventions.
Gradual approach: It's a stepping stone towards Exposure and Response Prevention (ERP), the gold-standard treatment for OCD.
Enhances control: Scheduling rituals can help the client feel more in control, reducing the urge to engage in them compulsively.
3. Addressing potential concerns:
Reinforcing rituals: While there's a possibility of temporarily reinforcing rituals, it's a necessary first step to build trust and engagement in therapy.
Interfering with treatment: Scheduling rituals is a part of a comprehensive treatment plan that includes ERP and other therapies to address the underlying causes of OCD.
4. Importance of individualized care:
The specific approach to planning for rituals should be tailored to the client's unique needs, preferences, and severity of symptoms.
Collaboration with the client is essential to ensure their active participation in treatment. I'll now address the rationales for the incorrect choices:
Choice B rationale:
Setting strict limits on behaviors can be counterproductive: Triggers anxiety and distress
Impedes trust and therapeutic alliance Diminishes sense of control
Heightens resistance to treatment
Choice C rationale:
Confronting the client about the senselessness of rituals is ineffective and potentially harmful: Exacerbates anxiety and shame
Alienates the client
Disregards the involuntary nature of OCD Undermines motivation for treatment Choice D rationale:
Isolating the client is unethical and detrimental:
Increases distress and loneliness Impedes therapeutic interactions Reinforces negative self-perceptions
Lacks evidence of efficacy in OCD treatment
Correct Answer is D
Explanation
Choice A rationale: Fear of rejection from staff is not typically a driving factor for the repetitive behaviors seen in OCD. While social anxiety can be a component of many mental health disorders, the compulsions in OCD are usually driven by intrusive thoughts or fears that are specific to the individual, rather than fears about social rejection.
Choice B rationale: Narcissistic Personality Disorder (NPD) is a separate condition from OCD. While individuals with NPD may exhibit certain repetitive behaviors, these are typically driven by a need for admiration and a lack of empathy for others, rather than the intrusive thoughts and fears that drive the compulsions in OCD12.
Choice C rationale: While certain medications can have side effects that might cause unusual behaviors, the repetitive behaviors (compulsions) seen in OCD are not typically a side effect of antidepressant medications. In fact, certain types of antidepressants are often used in the treatment of OCD12.
Choice D rationale: The repetitive behaviors observed in individuals with OCD, such as repeatedly applying, removing, and reapplying makeup, are indeed attempts to reduce anxiety. These individuals experience intrusive thoughts, fears, or images (obsessions) that cause significant anxiety. The repetitive behaviors (compulsions) are performed in an attempt to alleviate the distress caused by these obsessions. Despite the temporary relief, the individual often ends up trapped in a cycle of obsessions and compulsions.
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