A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating?

Rationalization

Compensation

Displacement

Denial

Answer and Explanation

The Correct Answer is C

The client is transferring his anger toward his partner to the nurse, who is a less threatening person.

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Correct Answer is C

Explanation

Command hallucinations are auditory hallucinations that instruct the client to perform an action, such as harming oneself or others. This is a medical emergency that requires immediate intervention by the nurse to ensure safety and prevent harm.

A. Monitor the child's vital signs every 15 min. B. Have the child perform range-of-motion exercises every 3 hr. C. Ensure three fingers will fit between the child's wrist and the restraint. D. Obtain a prescription for the restraints within 2 hr of initiating them.

Correct Answer is D

Explanation

The nurse should obtain a prescription for the restraints within 2 hr of initiating them, as this is a legal requirement and ensures that the restraints are used appropriately and safely. The other options are also important, but they are not the priority action in this situation.

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A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has delirium. Which of the following findings requires immediate intervention by the nurse?

Correct Answer is C

Explanation

A nurse is caring for a school-age child who has conduct disorder and requires wrist restraints. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is providing teaching to a client who is prescribed methylphenidate for ADHD. Which of the following statements by the client indicates accurate understanding of this medication's effects?

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A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating?

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