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:

Tingling of the scalp. Tingling of the scalp is not a common adverse reaction following electroconvulsive therapy (ECT) ECT primarily affects the brain and may result in memory-related side effects, but tingling of the scalp is not typically associated with this procedure.

Choice C rationale:

Voice alteration. Voice alteration is not a common adverse reaction to ECT. ECT is a procedure that involves inducing controlled seizures in the brain, and its primary effects are on cognitive and neurological function rather than the vocal cords or voice.

Choice D rationale:

Neck pain. Neck pain is not a common adverse reaction to ECT. This procedure primarily affects the brain and central nervous system, and neck pain is not typically associated with it.

Choice B rationale:

Temporary memory loss. Temporary memory loss is a well-documented and common adverse reaction to electroconvulsive therapy (ECT) ECT can affect memory consolidation, and clients may experience temporary memory gaps or difficulties recalling recent events. However, these memory deficits are usually short-term and improve over time.

A. Inquire about the client's bedtime routine. B. Recommend that the client go for a walk every morning. C. Instruct the client to turn off the television before bedtime. D. Encourage the client to listen to soft music at the onset of stress.

Correct Answer is A

Explanation

Choice A rationale:

Inquiring about the client's bedtime routine is the nurse's priority because it directly addresses the client's reported problem of insomnia due to increased stress. Understanding the client's routine can help identify factors contributing to sleep difficulties and guide the development of an appropriate plan of care.

Choice B rationale:

Recommending that the client go for a walk every morning may be a helpful intervention, but it does not directly address the client's immediate concern of insomnia. It's important to first assess the client's current situation and then provide tailored interventions.

Choice C rationale:

Instructing the client to turn off the television before bedtime is a good sleep hygiene practice, but it may not be the priority when the client is experiencing acute insomnia due to increased stress. The nurse should first gather information about the client's specific situation.

Choice D rationale:

Encouraging the client to listen to soft music at the onset of stress is a useful relaxation technique, but it may not be the priority in this case. The nurse should focus on addressing the client's insomnia by identifying contributing factors and implementing appropriate interventions.

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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?