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?

Suppression

Regression

Compensation

Sublimation

Answer and Explanation

The Correct Answer is A

A. Suppression:
Suppression is a psychological defense mechanism where an individual consciously avoids thinking about certain thoughts, emotions, or impulses. It involves intentionally putting aside disturbing or anxiety-inducing thoughts temporarily. People use suppression as a way to cope with overwhelming emotions or stressful situations by delaying dealing with them until they feel more prepared.

B. Regression:
Regression is a defense mechanism where an individual reverts to a previous stage of development in the face of stressful situations. For example, an adult may exhibit childlike behaviors or emotions during times of high stress. This regression is an unconscious way of seeking comfort and security from an earlier, less stressful time in life.

C. Compensation:
Compensation is a defense mechanism in which an individual tries to make up for a perceived deficiency in one area by excelling in another. For instance, someone who feels unattractive might compensate by becoming exceptionally skilled in a particular talent. Compensation involves overachieving in one area to cover up feelings of inadequacy in another.

D. Sublimation:
Sublimation is a defense mechanism where socially unacceptable impulses or urges are channeled into socially acceptable and productive activities. For example, someone with aggressive tendencies might channel their aggression into sports or artistic pursuits. Sublimation involves transforming negative emotions or desires into positive, socially acceptable behaviors.

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Correct Answer is A

Explanation

A. Recent head injury:
A recent head injury is a potential concern when considering the prescription of bupropion. Bupropion can lower the seizure threshold, and head injuries might increase the risk of seizures. Therefore, it's important to report a recent head injury to the healthcare provider to assess the client's suitability for bupropion.

B. Hepatitis B infection:
Hepatitis B infection is not a contraindication for bupropion. However, the healthcare provider should be aware of the client's full medical history, including hepatitis B infection, to ensure appropriate monitoring and management, especially if the client is taking other medications or has liver function concerns.

C. Hypothyroidism:
Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones, is not a contraindication for bupropion. However, the healthcare provider should be aware of this condition to monitor the client appropriately, as thyroid function can influence the metabolism of medications.

D. Knee arthroplasty 1 month ago:
Knee arthroplasty (knee replacement surgery) performed one month ago is not a direct contraindication for bupropion use. However, the provider should be informed of recent surgeries or procedures, especially if the client is taking medications or undergoing physical therapy, to ensure there are no potential drug interactions or complications related to the recent surgery. It's essential to monitor for signs of infection or other complications post-surgery.

A. "My partner and I recently had our fourth child." B. "My family has a history of suicide." C. “I have Crohn's disease, but it's well-controlled." D. “I just received my license to practice medicine."

Correct Answer is D

Explanation

A. "My partner and I recently had our fourth child."
Having a strong support system, such as a partner and family, especially during significant life events like the birth of a child, can be a protective factor against suicide. Supportive relationships are important for mental well-being.

B. "My family has a history of suicide."
A family history of suicide is a risk factor, not a protective factor. It indicates a higher risk for suicidal thoughts or behaviors.

C. “I have Crohn's disease, but it's well-controlled."
Having a chronic illness, even if well-controlled, can be a stressor, potentially increasing the risk of suicidal thoughts. It's not a protective factor.

D. “I just received my license to practice medicine."
Achieving a significant milestone, such as getting a medical license, can enhance self-esteem, provide a sense of purpose, and increase social support, making it a protective factor against suicide.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider?

Correct Answer is A

Explanation

A nurse is collecting a history from a client who has depression. Which of the following statements by the client should the nurse identify as a protective factor against suicide?

Correct Answer is D

Explanation

A nurse is leading a therapy session for a group of adolescent clients. Which of the following statements should the nurse identify as an adaptive use of ego defense mechanisms?

A nurse is caring for a client who has major depressive disorder and states that he has given away his personal belongings. Which of the following responses should the nurse make?

A nurse is assessing a client who experienced a sexual assault. Which of the following findings should the nurse identify as an indication the client might be experiencing posttraumatic stress disorder?

A nurse on a mental health unit placed a client in mechanical restraints after the client assaulted another client. Which of the following actions should the nurse take?

A nurse is assessing a client who has paranoid personality disorder. Which of the following findings should the nurse expect?

A nurse manager is observing a newly licensed nurse preparing to administer an IM medication to a client who is manic and refuses the medication. Which of the following actions should the nurse manager take first?

A nurse is providing teaching about disorder management for a client who has posttraumatic stress disorder (PTSD). Which of the following statements should the nurse include in the teaching?

A nurse is caring for a client who has physical restraints applied. The nurse determines that the restraints should be removed when which of the following occurs?