A nurse is assisting with teaching a class about cultural bias in health care. The nurse should include that which of the following can occur as a result of cultural bias?

Choice A reason : Repression is a defense mechanism that involves unconsciously blocking unpleasant feelings, desires, or experiences from one's awareness. It is a way for the ego to protect itself from things that the individual cannot cope with at the moment. In the scenario provided, the client does not seem to be unconsciously blocking out the stress but is instead consciously choosing to focus on different aspects of their life at different times.

Choice B reason : Compartmentalization is a defense mechanism where an individual separates different aspects of their life, allowing them to handle conflicting values or emotions by keeping these aspects in separate 'compartments' in their mind. This seems to be what the client is doing by separating work stress from family life, thus being able to concentrate on family when at home despite the stress at work.

Choice C reason : Regression is a defense mechanism that leads an individual to revert to an earlier stage of development when faced with stress. An example would be an adult throwing a tantrum when they don't get their way, which is not what the client is demonstrating in the scenario⁴.

Choice D reason : Projection is a defense mechanism where an individual attributes their own unacceptable thoughts, feelings, or motives to another person. For instance, someone who is angry at their colleague may accuse the colleague of being hostile towards them. The client's statement does not indicate that they are projecting their feelings onto others⁵.

Choice A reason : The "Good boy-nice girl" orientation is part of Kohlberg's Conventional level of moral development. In this stage, individuals are motivated by the desire to maintain relationships and gain approval from others. They make decisions based on what will please others and show concern for others by being "nice." This stage does not typically involve challenging rules but rather adhering to them to maintain social harmony⁴.

Choice B reason : The "Punishment and obedience" orientation is the first stage of Kohlberg's Preconventional level. Here, the focus is on direct consequences to the individual : actions are judged as good if they help avoid punishment. This stage is characterized by a literal obedience to rules and authority to avoid negative consequences, not by challenging them⁴.

Choice C reason : The "Law and order" orientation is the fourth stage, also within the Conventional level. In this stage, individuals are oriented to abiding by the law and respecting authority. They believe in maintaining the social order by following rules and laws. Challenging rules is not a characteristic of this stage; instead, there is a focus on upholding laws as they are⁴.

Choice D reason : The "Social contract" orientation is part of the Postconventional level of moral development, specifically the fifth stage. Individuals in this stage believe that rules and laws are flexible instruments for furthering human purposes. They can argue for the legality or principle behind the rule and may challenge rules that infringe on the rights of individuals. They understand that laws are created by people and can be changed by them. This stage involves the recognition that individual rights sometimes need to be upheld over and above the law⁴.