A nurse is caring for a client who appears anxious following a recent tragedy.
Which of the following statements by the client reflects an adaptive use of sublimation?
"I can't remember anything that happened, but I am okay."
"I'm not capable of moving past this time in my life."
"I do not have anxiety, and I'm not sure why you think I do."
"I will work out in the gym every time I get mad about what happened.".
The Correct Answer is D
Choice A rationale:
Repression: This statement suggests that the client is unconsciously blocking out memories of the tragedy as a way to cope with the anxiety. While repression can be a defense mechanism, it's not considered an adaptive use of sublimation.
Sublimation involves channeling anxiety into a productive or socially acceptable activity.
Denial of anxiety: The client's denial of anxiety, despite outward signs of distress, indicates a lack of awareness or acceptance of their emotional state. This can hinder effective coping and processing of the trauma.
Potential for delayed or prolonged distress: Repressed memories can resurface later, often in unexpected or disruptive ways, potentially leading to prolonged or intensified distress.
Choice B rationale:
Hopelessness and helplessness: The client's statement reflects a sense of defeat and a belief that they are incapable of overcoming the trauma. This can lead to feelings of despair, isolation, and withdrawal.
Lack of adaptive coping mechanisms: The client's inability to envision a future beyond the tragedy suggests a lack of healthy coping strategies to manage their anxiety and move forward.
Risk of prolonged distress and potential for depression: Persistent feelings of hopelessness and helplessness can increase the risk of developing depression or other mental health conditions.
Choice C rationale:
Denial of anxiety and potential lack of insight: The client's denial of anxiety, despite the nurse's observation, suggests a lack of awareness or acceptance of their emotional state. This can impede effective coping and processing of the trauma.
Potential resistance to support: The client's defensiveness may make it challenging for them to receive support or engage in therapeutic interventions.
Risk of delayed or unmanaged distress: If the client continues to deny their anxiety, they may not seek appropriate help, potentially leading to prolonged or intensified distress.
Choice D rationale:
Sublimation: This statement demonstrates the client's ability to channel their anxiety into a constructive and healthy outlet. Physical activity can provide a release for pent-up emotions, reduce stress, and improve overall well-being.
Adaptive coping mechanism: The client's choice to engage in physical activity as a way to manage their emotions indicates a positive coping strategy that can promote resilience and recovery.
Potential for improved mental and physical health: Regular exercise has numerous benefits for both mental and physical health, which can support the client's overall well-being and recovery process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer/s is:
C. Give positive feedback when the client is assertive with staff or clients.
Rationale for Choice A:
While setting limits is an important aspect of nursing care, it's not specifically targeted towards the core challenges of dependent personality disorder. The primary concern in this case is the client's excessive reliance on others and inability to function independently. Setting limits might be perceived as a rejection or abandonment, potentially exacerbating the client's distress and anxiety. Additionally, focusing on preventing the exploitation of other clients shifts the attention away from the client's individual needs and goals.
Rationale for Choice B:
While self-mutilation is a potential risk in some individuals with dependent personality disorder, it's not a defining characteristic or the most prevalent concern. Continuous close monitoring can be intrusive and undermine the client's sense of autonomy. It's more effective to build trust and establish open communication where the client feels comfortable expressing distress and seeking help before resorting to self-harm.
Rationale for Choice C:
Assertiveness is a key skill to cultivate in individuals with dependent personality disorder. It empowers them to express their needs and desires appropriately, reducing their reliance on others and fostering healthy relationships. Offering positive reinforcement when the client exhibits assertive behavior, even in small steps, strengthens this skill and motivates them to continue their progress. This positive reinforcement approach aligns with therapeutic interventions for dependent personality disorder, which focus on building self-confidence and fostering independent functioning.
Rationale for Choice D:
Discouraging flamboyant or seductive behaviors might seem relevant because some individuals with dependent personality disorder might resort to attention-seeking tactics. However, such an approach risks shaming or judging the client, potentially increasing their feelings of inadequacy and insecurity. It's important to understand the underlying reason behind these behaviors, which could be a desperate attempt to gain approval or validation. Addressing the core issue of low self-esteem and encouraging authentic self-expression are more productive strategies than simply suppressing certain behaviors.
Additional Notes:
In addition to the rationales for each choice, it's important to consider the overall treatment goals for dependent personality disorder. These goals typically include:
Reduced dependence on others: Encouraging the client to take responsibility for their own needs and decisions. Improved assertiveness skills: Enabling the client to express their wishes and opinions confidently.
Enhanced self-esteem: Building the client's confidence and sense of self-worth.
Developing healthy relationships: Fostering interactions based on mutual respect and independence.
When planning care for a client with dependent personality disorder, the nurse should collaborate with other healthcare professionals, such as therapists and social workers, to ensure a comprehensive and coordinated approach.
Correct Answer is C
Explanation
Rationale:
Choice A: While offering hope and highlighting potential positives can be important in supporting someone with depression, this statement feels dismissive of the client's current experience and minimizes the intensity of their feelings. It could inadvertently make them feel unheard and misunderstood.
Choice B: While acknowledging the commonality of these feelings in depression is important for normalization, it can feel impersonal and fail to address the individual's specific struggles. It focuses on the diagnosis rather than the person's unique experience.
Choice D: Asking "why" can feel interrogative and put pressure on the client to explain their complex emotions. The focus should be on actively listening and validating their feelings rather than seeking justifications.
Choice C: This response demonstrates active listening and reflects back the client's core feeling (lack of meaning) without judgment. It shows empathy and opens the door for further exploration of their thoughts and emotions. It encourages the client to elaborate on their experience and potentially identify areas where meaning can be rediscovered.
Elaboration:
Suicide ideation and attempts are often linked to feelings of hopelessness and a perceived lack of value or purpose in life. When caring for someone with major depressive disorder who has expressed these thoughts, the primary goal is to establish safety and create a space for open communication.
Using therapeutic communication techniques like reflection, validation, and open-ended s allows the nurse to build trust and rapport with the client. Reflecting their feelings, as in Choice C, demonstrates understanding and helps the client feel heard and accepted. This can be a crucial step in reducing their distress and fostering a sense of hope and possibility.
By creating a safe and supportive environment, the nurse can encourage the client to explore their thoughts and feelings about their life and identify potential sources of meaning and hope. This can be a vital step in their journey towards recovery and well-being.
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