A nurse is assessing a client who has a recent diagnosis of dissociative identity disorder. The client tells the nurse, "I think my blackouts are actually caused by low blood sugar." The nurse should recognize the client is using which of the following defense mechanisms?
Suppression
Sublimation
Projection
Rationalization
The Correct Answer is D
Choice A reason: Suppression is a conscious decision to delay paying attention to an emotion or need in order to cope with the present reality. It's unlikely that the client is consciously choosing to ignore the cause of their blackouts.
Choice B reason: Sublimation is a way of dealing with unacceptable impulses by unconsciously substituting acceptable forms of expression. This defense mechanism doesn't typically apply to explaining symptoms like blackouts.
Choice C reason: Projection involves attributing one's own unacceptable thoughts or feelings to another person. Since the client is providing an explanation for their own symptoms, rather than attributing them to someone else, projection is not the defense mechanism at play here.
Choice D reason: Rationalization involves justifying behaviors or feelings with logical reasons, even if they are not appropriate. The client's attribution of blackouts to low blood sugar, despite a diagnosis that suggests a psychological cause, is a form of rationalization.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Asking the client about their hallucinations can provide valuable information about the content and nature of the hallucinations. This can help the nurse assess the client's current mental state and the potential impact of the hallucinations on their behavior and safety.
Choice B reason: Focusing the client on reality-based topics is a strategy that can be used after understanding the client's hallucinations. It's important to first acknowledge the client's experience before attempting to redirect their attention.
Choice C reason: Taking the client for a walk may be a good distraction technique, but it should not be the first action. The nurse needs to assess the client's safety and the potential risks associated with the hallucinations before engaging in activities.
Choice D reason: Encouraging the client to listen to music can be a therapeutic intervention to help distract from hallucinations. However, it is not the first action to take. The nurse should first understand the client's experience and ensure their safety.
Correct Answer is B
Explanation
Choice A reason: Intensive Outpatient Programs (IOPs) offer structured treatment for mental health and substance misuse concerns, providing therapy for a few hours a day, several days a week. While beneficial, they may not offer the comprehensive, round-the-clock support needed by someone with a chronic mental illness.
Choice B reason: Assertive Community Treatment (ACT) is a form of community-based mental health care designed to help individuals with serious mental illnesses manage their symptoms and live independently in the community. ACT involves a multidisciplinary team approach and provides round-the-clock services, making it an ideal resource for chronic mental illness management.
Choice C reason: Patient-Centered Medical Homes (PCMHs) focus on providing comprehensive, coordinated care that is patient-centered and culturally appropriate. Although PCMHs offer a broad range of services, they may not be as intensive as ACT for managing chronic mental illness.
Choice D reason: Partial Hospitalization Programs (PHPs) are intensive outpatient treatment programs that allow patients to live at home while receiving daily treatment at a facility. PHPs are more intensive than IOPs but less so than inpatient care, and they may not provide the continuous support that ACT offers for chronic mental illness.
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