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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E","F"]
Explanation
Choice A rationale:
Performing intermittent external electronic fetal monitoring is not the best choice in this situation. The client’s condition, which includes severe abdominal pain, vaginal bleeding, rigid and tender abdomen, and late decelerations in the fetal heart rate, suggests a possible placental abruption. In such a case, continuous fetal monitoring is required to closely monitor the fetal heart rate and contractions.
Choice B rationale:
Monitoring vital signs at least every 15 min is necessary. The client’s blood pressure has dropped from 110/68 mm Hg to 95/59 mm Hg within 15 minutes. This could indicate hypovolemia due to blood loss. Regular monitoring can help detect changes early and initiate appropriate interventions.
Choice C rationale:
Placing the client in a supine position is not recommended. This position can exacerbate supine hypotensive syndrome, which occurs when the gravid uterus compresses the inferior vena cava, reducing venous return and cardiac output. A side-lying position would be more appropriate.
Choice D rationale:
Obtaining a type and crossmatch is crucial. The client’s symptoms suggest a possible placental abruption, which can lead to significant blood loss. Having blood available for transfusion can be lifesaving.
Choice E rationale:
Measuring blood loss by weighing pads can provide an objective assessment of blood loss. This can help guide treatment decisions, including the need for blood transfusion.
Choice F rationale:
Inserting a large-bore IV catheter is necessary in this situation. It allows for rapid fluid and blood replacement if needed. Given the client’s symptoms and the potential for significant blood loss with placental abruption, this intervention is appropriate.
Correct Answer is D
Explanation
Choice A rationale:
"This medication will darken the color of my eyes." This statement is not accurate. Timolol eye drops, which are commonly used to treat glaucoma, do not darken the color of the eyes. This statement indicates a misunderstanding of the medication's effects.
Choice B rationale:
"This medication will dilate my eyes." This statement is not accurate either. Timolol is a beta-blocker that works to reduce intraocular pressure by decreasing the production of aqueous humor in the eye. It does not dilate the eyes; in fact, it has the opposite effect.
Choice C rationale:
"I should take a zinc supplement while taking this medication." This statement is unrelated to the use of timolol eye drops for glaucoma and is not part of the standard treatment plan. There is no established connection between taking zinc supplements and using timolol for glaucoma management.
Choice D rationale:
"I should check my heart rate while taking this medication." This statement indicates an understanding of the teaching. Timolol is a beta-blocker that can lower heart rate and blood pressure. Clients using timolol eye drops should be advised to monitor their heart rate regularly and report any significant changes to their healthcare provider. This is important for safety and to ensure that the medication is not causing any adverse cardiovascular effects.
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