A nurse is caring for a client who has a new diagnosis of metastatic lung cancer. The client states, "I can't think about that until after my first grandchild is born next week." The nurse should identify the client's statement as indicating the maladaptive use of which of the following defense mechanisms?

Choice A reason:
Informing the client about confidentiality rights is an essential part of the initial orientation phase of a therapeutic relationship. This is when the nurse and client establish the parameters of the relationship, including confidentiality. However, this is not typically a task for the working phase.

Choice B reason:
During the working phase of a therapeutic relationship, the nurse's primary task is to evaluate progress toward predetermined goals. This phase involves active problem-solving and implementing nursing interventions. The nurse and client work together to address problems and issues, and it is crucial to assess whether the interventions are effective and if the goals are being met.

Choice C reason:
Establishing boundaries between the nurse and the client is another task that occurs during the orientation phase. Clear boundaries are necessary for a professional and therapeutic relationship, but they are set at the beginning and maintained throughout the relationship, not just during the working phase.

Choice D reason:
Setting short- and long-term objectives is part of both the orientation and working phases. While objectives may be initially set during the orientation phase, they can be revisited and adjusted during the working phase as needed. However, the primary focus of the working phase is on evaluating progress, not setting objectives.

Choice A reason:
Placing the client in a reclining chair is not a recommended intervention for managing wandering behavior. While it might seem like a way to keep the client stationary, it does not address the underlying issue of wandering and can lead to discomfort or pressure sores if the client remains in the chair for extended periods.

Choice B reason:
Installing sensor devices on outside doors is an effective intervention. These devices can alert caregivers when the client attempts to leave the house, thereby preventing wandering and potential falls. This measure enhances safety by providing immediate notification of the client's movements.

Choice C reason:
Positioning the mattress on the floor can help prevent injuries from falls. If the client rolls out of bed, the risk of injury is minimized because the fall distance is significantly reduced. This is a practical solution for clients who are prone to falling out of bed.

Choice D reason:
Encouraging physical activity prior to bedtime can be beneficial for overall health but may not be the best strategy for managing nighttime wandering. Physical activity should be balanced and not too close to bedtime, as it can sometimes lead to increased alertness rather than promoting sleep.

Choice E reason:
Putting locks at the top of doors is a useful safety measure. Clients with Alzheimer's disease may not notice or be able to reach locks placed higher up, which can prevent them from wandering outside unsupervised. This intervention helps ensure the client's safety by restricting access to potentially dangerous areas.