A nurse is assessing a client who has multiple injuries from a motor vehicle crash as a result of driving while under the influence of alcohol. The client tells the nurse," I had a few drinks after my boss fired me, but it's okay. Everything will work out somehow next week." Which of the following defense mechanisms is the client demonstrating?

Dissociation

Projection

Intellectualization

Suppression

Answer and Explanation

The Correct Answer is D

Answer: (D) Suppression

Rationale:

A) Dissociation: Dissociation involves a disconnection from reality or the separation of thoughts, memories, or identity from conscious awareness. In this scenario, the client is not displaying any signs of disconnecting from reality or avoiding awareness of the situation through dissociation, making this defense mechanism unlikely.

B) Projection: Projection occurs when an individual attributes their own unacceptable thoughts or feelings to others. The client in this situation is not blaming others or attributing their actions to someone else, so projection is not the defense mechanism being demonstrated here.

C) Intellectualization: Intellectualization involves using reasoning or logic to avoid emotional stress or anxiety. While the client does mention logical-sounding plans about things working out next week, their overall response does not primarily reflect an avoidance of emotion through reasoning, so intellectualization is not the correct choice.

D) Suppression: Suppression is the conscious decision to delay paying attention to an emotion or need in order to cope with the present situation. The client acknowledges the stress of being fired but chooses to push aside their distress by stating that "everything will work out somehow next week," indicating they are consciously choosing to set aside their anxiety for the time being. This aligns with the concept of suppression.

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Correct Answer is C

Explanation

Projection is a defense mechanism where an individual attributes their own undesirable thoughts, feelings, or impulses onto someone else. In this case, the client is projecting their own desire to go out and have a drink onto the nurse and others involved in their care. They are attributing their own feelings to others in an attempt to avoid acknowledging or taking responsibility for their own desires.

A- Reaction-formation is a defense mechanism where an individual expresses the opposite of their true feelings or impulses.

B- Compensation is a defense mechanism where an individual tries to make up for their perceived deficiencies by excelling in another area.

D- Identification is a defense mechanism where an individual models their behavior after someone they admire.

A. "It sounds like you're having a difficult time." B. "Why do you think you are so anxious?" C. "Everyone has trouble sleeping at times." D. "Have you talked to your provider about this yet?"

Correct Answer is A

Explanation

The response "It sounds like you're having a difficult time" acknowledges the client's distress and validates their experience. It demonstrates empathy and shows the nurse's willingness to listen and provide support. This response encourages the client to express their feelings and concerns further, facilitating open communication and a therapeutic relationship.

The response "Why do you think you are so anxious?" may come across as confrontational or intrusive. It puts the client on the spot and may make them feel defensive or uncomfortable. It is important to create a supportive environment where the client feels safe to share their experiences without judgment.

The response "Everyone has trouble sleeping at times" minimizes the client's concerns and may invalidate their feelings. It does not address the client's anxiety or offer any support or guidance.

The response "Have you talked to your provider about this yet?" is a helpful question to explore whether the client has sought professional help. However, it should be used after acknowledging the client's difficulties and showing empathy. It can be part of a conversation about accessing appropriate care and resources.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the court-ordered admission of a client to a substance-abuse program. The client states, "You are all angry at me and wish you could go out and have a drink." The client's response is an example of which of the following defense mechanisms?

Correct Answer is C

Explanation

A nurse is caring for a client who reports a state of Increasing anxiety and the inability to sleep and concentrate. Which of the following is an appropriate response by the nurse?

Correct Answer is A

Explanation

A nurse is helping a client relieve stress through cognitive reframing. Which of the following actions by the client demonstrates effective use of cognitive reframing?

A nurse is collecting data from a client whose child was killed 2 years ago. Which of the following actions Indicates that the client is experiencing maladaptive grieving?

A nurse is caring for a client in an acute care mental health unit who was involuntarily admitted for 72 hr after attacking a neighbor. To keep the client in the hospital when the initial time to hold the client expires, which of the following must be determined?

A nurse is discussing legal exceptions to client confidentiality with nursing staff. Which of the following statements by a staff member indicates an understanding?

A nurse is reinforcing teaching with a client who is scheduled to receive electroconvulsive therapy (ECT). Which of the following statements should the nurse include in the teaching?

A nurse is caring for a client who is scheduled for electroconvulsive therapy In 1 hr. The client asks the nurse, "Can I refuse today's treatment?" Which of the following responses should the nurse make?

A nurse is planning an Interview for a newly admitted client and plans to Include the client's family members. Which of the following methods should the nurse use to determine who to include in the interview?