A nurse is assessing the coping strategies of a client who has recently retired.
Which of the following statements by the client indicates that the client is using compensation as a defense mechanism?

"Since I retired, I have entered many gardening competitions."

"I'm so glad I've retired because the work was making me sick and depressed."

"I had to retire because my boss didn't like me."

"There were lay-offs at my company, so I journaled about what I accomplished during my career." .

Answer and Explanation

The Correct Answer is A

Choice A rationale:

"Since I retired, I have entered many gardening competitions." This statement indicates compensation as a defense mechanism. Compensation involves emphasizing personal strengths in one area to shift focus from failure or weakness in another. In this case, the client is finding fulfillment and recognition in gardening competitions after retiring, compensating for the loss of work-related identity.

Choice B rationale:

Expressing relief about retirement due to negative work experiences doesn’t necessarily indicate compensation. It could be a coping mechanism, but it doesn't align with the compensation defense mechanism, which involves overachieving in one area to compensate for deficiencies in another.

Choice C rationale:

Choice D rationale:

Journaling about career accomplishments after layoffs indicates sublimation, not compensation. Sublimation is a defense mechanism where unacceptable impulses or behaviors are transformed into socially acceptable actions or pursuits, like channeling frustration or disappointment into creative or productive activities such as journaling.

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Correct Answer is B

Explanation

Choice A rationale:

Acetone breath is a symptom of diabetic ketoacidosis (DKA), a complication of diabetes mellitus. It occurs due to the presence of ketones in the breath and is not specific to hypoglycemia. Hypoglycemia is characterized by low blood sugar levels, not elevated ketone levels.

Choice B rationale:

Confusion is a common symptom of hypoglycemia. When blood sugar levels drop significantly, the brain may not receive enough glucose to function properly, leading to confusion, dizziness, and other neurological symptoms.

Choice C rationale:

Polydipsia refers to excessive thirst and is a symptom of hyperglycemia (high blood sugar levels), not hypoglycemia. In hyperglycemic states, the body tries to eliminate excess glucose through urine, leading to increased thirst.

Choice D rationale:

Hot, dry skin is not a typical symptom of hypoglycemia. Hypoglycemia can cause diaphoresis (excessive sweating) and cool, clammy skin due to the body's stress response.

A. Keep an abduction pillow between the client's legs. B. Elevate the client's affected leg on a pillow when in bed. C. Position the client's knees slightly higher than the hips when up in a chair. D. Raise the head of the client's bed to a high-Fowler's position.

Correct Answer is A

Explanation

Choice A rationale:

Keeping an abduction pillow between the client's legs is a preventive measure to avoid dislocation of the hip prosthesis. This positioning helps maintain the correct alignment of the hip joint, reducing the risk of dislocation. Abduction pillows are commonly used postoperatively after total hip arthroplasty to support proper hip positioning while the patient is in bed.

Choice B rationale:

Elevating the client's affected leg on a pillow when in bed is not recommended after total hip arthroplasty. This position could lead to hip adduction, increasing the risk of prosthesis dislocation. Maintaining abduction (spreading the legs apart) is the key to preventing dislocation, and elevation should be avoided to maintain proper alignment.

Choice C rationale:

Positioning the client's knees slightly higher than the hips when up in a chair is not an appropriate preventive measure for prosthesis dislocation. Proper alignment is crucial, and the client should avoid sitting in low chairs or on low surfaces that could cause the hips to be lower than the knees, potentially leading to dislocation.

Choice D rationale:

Raising the head of the client's bed to a high-Fowler's position is unrelated to preventing prosthesis dislocation. Fowler's position refers to elevating the head of the bed to assist with breathing and facilitate patient comfort. While this position might be suitable for certain respiratory conditions, it has no direct impact on the stability of a hip prosthesis.

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A nurse is assessing the coping strategies of a client who has recently retired.Which of the following statements by the client indicates that the client is using compensation as a defense mechanism?

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A nurse is assessing the coping strategies of a client who has recently retired.
Which of the following statements by the client indicates that the client is using compensation as a defense mechanism?