A nurse is caring for a client who smokes and has lung cancer. The client reports, “I'm coughing because I have that cold that everyone has been getting.”
The nurse should identify that the client is using which of the following defense mechanisms?
Denial
Reaction formation
Sublimation
Suppression
The Correct Answer is A
Denial is a defense mechanism where an individual refuses to accept or acknowledge the existence of a problem or a reality that causes anxiety or distress. In this scenario, the client is denying that their coughing is related to their lung cancer, and instead attributing it to a common cold that everyone is getting. This denial may be a way for the client to avoid facing the reality of their illness and the potential consequences of smoking.
Option b, reaction formation, is a defense mechanism where an individual expresses feelings or behaviors that are the opposite of their true feelings to reduce anxiety.
Option c, sublimation, is a defense mechanism where an individual channels their unacceptable impulses into more acceptable or socially appropriate behaviors.
Option d, suppression, is a defense mechanism where an individual consciously pushes down or avoids their thoughts or feelings. None of these defense mechanisms are being exhibited in the scenario described.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
In this scenario, the client has expressed a serious threat to harm someone, which triggers a healthcare provider's duty to warn law. The nurse appropriately informed the healthcare provider, who then informed their boss, to protect the potential victim from harm. This action is not a violation of privacy or confidentiality, as it is necessary for the safety and wellbeing of others.
Therefore, no disciplinary action is required for the nurse or the healthcare provider, as they acted in accordance with their professional and legal obligations to protect the safety of others.
Correct Answer is C
Explanation
Manipulative behavior is not acceptable in any situation, and it is important for the nurse to set clear boundaries and expectations with the client. Allowing manipulation can enable the client's behavior and reinforce it. Avoiding discussing past or present manipulative behaviors with the client may not effectively address the issue and could potentially worsen the behavior. Bargaining with the client can also reinforce manipulative behavior.
Therefore, instituting consequences for manipulative behavior is the most appropriate intervention to include in the plan of care. This could involve setting clear limits on what is acceptable behavior and consistently enforcing consequences when those limits are exceeded. The consequences should be communicated clearly to the client, and the nurse should work with the client to identify more appropriate ways to communicate their needs and concerns.
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