A nurse is caring for a client who has bipolar disorder.
The client yells at the nurse whenever medication changes are prescribed by the client's provider.
The nurse should identify that the client is using which of the following defense mechanisms?

Displacement.

Splitting.

Sublimation.

Conversion.

Answer and Explanation

The Correct Answer is A

The correct answer is: a. Displacement.

Choice A Reason: Displacement is a defense mechanism where a person redirects a negative emotion from its original source to a less threatening recipient. In the context of bipolar disorder, a client may displace anger or frustration about their condition or treatment onto the nurse, who is not the source of these feelings. This redirection can occur because the client might feel powerless or uncomfortable expressing these emotions towards their healthcare provider, who is the authority figure prescribing medication changes.

Choice B Reason: Splitting is often associated with borderline personality disorder rather than bipolar disorder. It involves viewing things in extremes—either all good or all bad—with no middle ground. While individuals with bipolar disorder can exhibit black-and-white thinking, especially during mood episodes, the behavior described does not indicate splitting, as it does not involve idealizing or devaluing the nurse or provider.

Choice C Reason: Sublimation is a mature defense mechanism where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior, often resulting in a long-term conversion of the initial impulse. For example, a person with aggressive tendencies might take up a sport that channels aggression in a socially acceptable way. The scenario provided does not suggest that the client is channeling their frustrations into a constructive activity.

Choice D Reason: Conversion involves the transfer of mental stress into physical symptoms. This defense mechanism is characteristic of conversion disorder, where psychological stress manifests as neurological symptoms like blindness, paralysis, or other sensory or motor symptoms without a medical cause. The client yelling at the nurse does not reflect a conversion of emotional distress into physical symptoms.

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Correct Answer is B

Explanation

Choice A rationale:

Hospice care is typically recommended for clients with a terminal illness who are no longer seeking curative treatment. It may not be suitable for an older adult with early onset dementia unless their condition is very advanced.

Choice B rationale:

Recommending an adult day care facility is appropriate in this situation. Adult day care centers provide a safe and stimulating environment for older adults who require supervision and socialization during the day. It can be a helpful resource for the client's care while the adult child is at work.

Choice C rationale:

Suggesting a community senior center is a good option for social engagement and activities, but it may not provide the level of supervision and care needed for an older adult with dementia, especially if the adult child works full-time.

Choice D rationale:

Recommending a long-term care facility is a more drastic step and is typically considered when a client's care needs cannot be met at home or in less restrictive settings. It may not be necessary for a client with early onset dementia who still has family support.

A. Sarcoptes scabiei. B. Neisseria gonorrhoeae. C. Human papillomavirus. D. Impetigo contagiosa.

Correct Answer is B

Explanation

Choice A rationale:

Sarcoptes scabiei is the causative agent of scabies, a contagious skin infestation. While scabies is a communicable disease, it is typically not a reportable disease to the state health department. Scabies is usually treated at the individual or community level, and reporting to the state health department is not required.

Choice B rationale:

Neisseria gonorrhoeae is the bacterium responsible for gonorrhea, a sexually transmitted infection. Gonorrhea is a notifiable disease, and healthcare providers are required to report cases of gonorrhea to the state health department. This is because gonorrhea is a significant public health concern due to its potential complications and the need for contact tracing and prevention.

Choice C rationale:

Human papillomavirus (HPV) is a very common sexually transmitted infection, but it is typically not a reportable disease to the state health department. HPV can lead to various health issues, including genital warts and certain types of cancer. However, reporting HPV cases is not a standard practice because it is highly prevalent and usually managed at the individual level through screening and vaccination programs.

Choice D rationale:

Impetigo contagiosa is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. While it is contagious, impetigo is not typically a reportable disease to the state health department. Like scabies, impetigo is usually managed at the individual or community level, and reporting is not a standard requirement.

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A nurse is caring for a client who has bipolar disorder. The client yells at the nurse whenever medication changes are prescribed by the client's provider. The nurse should identify that the client is using which of the following defense mechanisms?

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A nurse is caring for a client who has bipolar disorder.
The client yells at the nurse whenever medication changes are prescribed by the client's provider.
The nurse should identify that the client is using which of the following defense mechanisms?