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 ["A","B","C","D"]
Explanation
Choice A rationale:
Altered body image is a hallmark feature of eating disorders. Individuals with eating disorders often have a distorted perception of their bodies, believing they are overweight or larger than they actually are. This distorted body image can lead to intense dissatisfaction with their appearance, even when they are underweight. They may engage in obsessive behaviors such as repeatedly checking their weight, measuring their body parts, and avoiding mirrors. They may also fixate on perceived flaws in their appearance, leading to significant distress and impairment in their daily lives.
Choice B rationale:
Amenorrhea, the absence of menstruation, is a common physiological consequence of eating disorders. It occurs due to hormonal imbalances caused by insufficient intake of calories and nutrients, particularly fat. The body requires a certain amount of body fat to maintain normal reproductive function. When body fat levels fall below a critical threshold, the hypothalamus, a part of the brain that regulates hormone production, signals the pituitary gland to reduce the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones play crucial roles in ovulation and menstruation. Without adequate levels of FSH and LH, ovulation and menstruation do not occur.
Choice C rationale:
Hyperactivity, characterized by excessive energy and restlessness, can manifest in individuals with eating disorders. This increased activity level may be a way to burn calories or compensate for perceived overeating. It may also be a way to distract themselves from thoughts about food and body image. The hyperactivity can present in various forms, such as excessive exercise, fidgeting, or constant movement.
Choice D rationale:
Bradycardia, a slower-than-normal heart rate, is another physiological sign that can accompany eating disorders. It occurs as the body attempts to conserve energy in response to inadequate caloric intake. The heart rate slows down to minimize energy expenditure. Bradycardia can have serious health implications, including fatigue, dizziness, fainting spells, and potentially life- threatening heart arrhythmias.
Choice E rationale:
Verbalized desire to gain weight is not a typical manifestation of eating disorders. Individuals with eating disorders often have a strong fear of weight gain and a persistent drive for thinness. They may actively resist efforts to increase their weight, even when they are dangerously underweight.
Correct Answer is C
Explanation
Choice A rationale:
While it's true that the nurse has released the client's information without their explicit consent, this action is justified under the duty to warn and protect.
This duty supersedes the general obligation to maintain confidentiality when there's a serious and imminent threat to identifiable individuals or the public.
In this case, the client's verbal threat to bomb a local church constitutes a credible and foreseeable risk of harm, necessitating the breach of confidentiality to protect potential victims.
Choice B rationale:
Although the nurse's actions may help to avoid malpractice charges by demonstrating responsible care and adherence to ethical obligations, this is not the primary reason for notifying the minister.
The primary goal is to avert harm and fulfill the duty to warn, not to shield oneself from legal liability.
Choice C rationale:
This is the correct answer. The nurse has acted in accordance with the duty to warn and protect, which is a legal and ethical obligation in healthcare.
This duty mandates that healthcare professionals take reasonable steps to warn potential victims and protect the public when a patient communicates a serious threat of harm.
Choice D rationale:
While confidentiality is a cornerstone of healthcare ethics, it's not absolute.
The duty to warn and protect allows for limited breaches of confidentiality when necessary to prevent serious harm, as in this case.
The nurse's actions align with ethical principles and legal requirements, even though they involve disclosing confidential information.
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