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?

Denial

Compensation

Rationalization

Displacement

Answer and Explanation

The Correct Answer is D

A. Denial:
Denial is a defense mechanism in which a person refuses to accept reality or acknowledge the existence of something that is evident to others. For example, a person diagnosed with a serious illness might deny that they are ill or refuse to believe the diagnosis. In this scenario, the client is not denying a reality; he is expressing anger and directing it toward the nurse.

B. Compensation:
Compensation is a defense mechanism where an individual overachieves in one area to compensate for real or imagined deficiencies in another area. For instance, someone who feels intellectually inferior might excel in sports to compensate for their perceived inadequacy. This is not applicable to the client's situation in the scenario provided.

C. Rationalization:
Rationalization involves providing logical or reasonable explanations to justify behaviors or feelings that might otherwise be unacceptable. For instance, a person might rationalize a failure by blaming external factors rather than accepting personal responsibility. In the scenario, the client is not offering rationalizations but is expressing direct anger.

D. Displacement:
Displacement occurs when emotions, especially anger or frustration, are redirected from the original source to a less threatening target. For example, a person who is angry with their boss might come home and take out their frustration on their family members. In the given situation, the client is displacing his anger from his partner onto the nurse, asking her to leave, making displacement the most appropriate choice.

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Correct Answer is B

Explanation

A. The client expresses feelings of guilt.
Feelings of guilt are a common part of the grieving process. Many people may experience guilt related to things they said or didn't say, things they did or didn't do before their loved one's death. While it can be challenging, it is not necessarily a maladaptive grief response.

B. The client is unable to perform basic hygiene tasks.
This indicates a maladaptive grief response. If the client's grief has led to such severe impairment in functioning that they cannot maintain basic hygiene, it suggests an inability to cope and function in daily life, which is concerning and requires intervention and support.

C. The client gives away some of the partner's belongings.
This behavior is a common part of the grieving process. It can represent the client's attempt to let go and move on. It might also be an expression of their partner's wishes or a way to help others in need. Giving away belongings is not inherently maladaptive; it depends on the context and the individual's overall coping abilities.

D. The client relocates from a house to an apartment.
Changes in living arrangements after the loss of a loved one are often part of adapting to the new circumstances. It can be a way for the individual to reduce their responsibilities, live in a more manageable space, or seek a fresh start. Relocating, on its own, is not a maladaptive response to grief.

A. "I will do my best to avoid crying in front of my loved ones." B. “I will stay in bed on days when I feel exhausted." C. “I’ll use the coping mechanisms that helped me in the past." D. “I will avoid talking about events that upset me."

Correct Answer is C

Explanation

A. "I will do my best to avoid crying in front of my loved ones."
This statement suggests the client might be trying to hide their emotions, which can lead to further emotional distress. Suppressing emotions, like crying, is not a healthy coping mechanism and can exacerbate feelings of sadness and isolation.

B. “I will stay in bed on days when I feel exhausted."
Staying in bed excessively, especially during the day, is a behavior associated with depression and can worsen depressive symptoms. Encouraging the client to maintain a regular sleep schedule and engage in activities, even if they are small, is a more beneficial approach. Physical activity and exposure to natural light can positively impact mood.

C. “I’ll use the coping mechanisms that helped me in the past."
This is the correct choice. Reverting to previously effective coping mechanisms indicates an understanding of self-awareness and the ability to recognize what has worked positively in the past. Coping mechanisms such as relaxation techniques, hobbies, social support, or therapy can be valuable tools in managing depressive symptoms.

D. “I will avoid talking about events that upset me."
Avoiding discussions about upsetting events can prevent the client from addressing and processing their emotions, hindering the therapeutic process. Encouraging open communication and expressing feelings with a trusted individual, therapist, or support group can help the client work through emotional challenges.

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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

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