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A nurse is assessing a young adult client who has a new diagnosis of Idiopathic Juvenile arthritis. The client states. "The pain in my joints is just a temporary thing. If I keep eating right and exercising, it'll go away." The nurse should identify that the client is using which of the following defense mechanisms?

Displacement

Reaction formation

Denial

Rationalization

Answer and Explanation

The Correct Answer is C

Answer: C

Rationale:

A) Displacement:

Displacement involves redirecting emotions or feelings from the original source to a safer or more acceptable substitute. In this scenario, the client is not redirecting their feelings about their condition onto another person or object, so displacement does not apply.

B) Reaction formation:

Reaction formation is when a person behaves in a way that is opposite to their actual feelings or thoughts to conceal them. The client is not expressing the opposite of their true feelings about their condition; instead, they are downplaying the seriousness of their diagnosis.

C) Denial:

Denial involves refusing to accept reality or facts, thus blocking external events from awareness. By believing that proper diet and exercise alone will make the joint pain go away, the client is refusing to accept the chronic nature of their condition and its long-term implications.

D) Rationalization:

Rationalization involves creating logical reasons or excuses for behaviors or feelings to avoid facing the true reasons. The client is not making excuses or trying to justify their feelings; instead, they are denying the chronic nature of their arthritis, which makes denial the correct defense mechanism in this context.

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Correct Answer is D

Explanation

Effective use of cognitive reframing involves shifting negative thoughts or perspectives into more positive and realistic ones. By learning to change negative thoughts into positive statements, the client is actively engaging in cognitive reframing techniques. This process allows the client to challenge and reframe negative thinking patterns, which can help reduce stress and promote a more positive outlook.

Incorrect:

A. Training the mind to relax by using deep inner resources is a helpful technique for relaxation and stress reduction. However, it does not specifically involve cognitive reframing, which focuses on modifying thought patterns and perspectives.

B. Learning the source of stress by writing down daily events can be a useful tool for

self-awareness and understanding triggers. While it may contribute to stress management, it does not directly involve cognitive reframing.

C. Imagining being in a quiet, relaxing environment can be a relaxation technique that helps reduce stress. However, it is not specifically related to cognitive reframing, which centers on changing thought patterns.

A. Share personal information to help the client feel comfortable. B. Develop an emotional commitment to the client. C. That he reminds the nurse of a personal friend or relative D. Maintain boundaries with the client regarding personal space.

Correct Answer is D

Explanation

It is important for the nurse to establish and maintain appropriate professional boundaries with the client. This includes respecting the client's personal space and privacy. By maintaining appropriate boundaries, the nurse ensures a therapeutic and professional relationship that focuses on the client's needs and promotes their well-being.
The other options are not appropriate when developing a relationship with the client:

1. Share personal information to help the client feel comfortable: While it is important to build rapport and create a supportive environment, sharing personal information may blur professional boundaries and divert the focus from the client to the nurse. The therapeutic relationship should primarily revolve around the client's needs and experiences.
2. Develop an emotional commitment to the client: While empathy and compassion are essential in providing care, it is important for the nurse to maintain professional objectivity. Developing an emotional commitment can make it challenging for the nurse to maintain appropriate boundaries and could lead to potential ethical issues.
3. He reminds the nurse of a personal friend or relative: It is important for the nurse to remain unbiased and treat each client as an individual. Drawing comparisons or associations with personal acquaintances can influence the nurse's objectivity and professionalism in providing care.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

A nurse is caring for a client who has a major depressive disorder. Which of the following actions should the nurse take when developing a relationship with the client?

Correct Answer is D

Explanation

A nurse is caring for a client following the recent, sudden death of his partner. The client says, "I feel paralyzed and can't seem to cope with work or family responsibilities anymore." Which of the following types of crisis is the client demonstrating?

A nurse on an inpatient mental health unit is caring for a group of clients. Which of the following actions by the nurse demonstrates the ethical concept of autonomy?

A nurse is preparing to change the dressing on the lower leg of an older adult client who is in a wheelchair, and has a history of maladaptive coping skills. The client begins swearing at and verbally abusing the nurse. Which of the following actions should the nurse take?

A nurse is caring for a client who begins to make sexual advances towards him. Which of the following is an appropriate statement by the nurse?

A nurse in an acute care mental health unit is speaking with a client who reports that other clients leave trash in the lounge. Which of the following actions should the nurse take?

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 observes that a client is sitting alone in her room crying. As the nurse approaches, she states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following responses is appropriate for the nurse?