A nurse is caring for a client who states, "I am under a great deal of stress at work, but I am able to forget my work and concentrate on my family when I get home at night." The nurse should identify that the client is demonstrating which of the following defense mechanisms?

Choice A reason : Prolonged grief, also known as complicated grief, is characterized by an intense longing and preoccupation with thoughts or memories of a loved one, which persists long after the loss has occurred. It can significantly impair important areas of functioning and is defined by the DSM-5-TR as grief that stays with you long-term. The client's inability to accept the loss after three years suggests that they may be experiencing prolonged grief, which may require the guidance of a mental health professional for resolution.

Choice B reason : Uncomplicated grief, also known as normal grief, involves a range of feelings, including sadness, anger, and longing, that gradually start to improve over time. The person experiencing uncomplicated grief will begin to accept the loss and resume normal activities. Since the client is still unable to accept the loss after three years, this would not be classified as uncomplicated grief.

Choice C reason : Disenfranchised grief occurs when an individual's grief is not acknowledged or validated by society, often because the relationship to the deceased is not recognized, such as in the case of a pet or a distant relative. This type of grief is not typically associated with the duration of the grief but rather with the social context in which the grieving occurs.

Choice D reason : Anticipatory grief occurs before the actual loss, often in situations where a loved one is terminally ill. It involves grieving the impending loss and can include some of the same emotions as post-loss grief. Since the client's partner has already died, this would not be considered anticipatory grief.

Choice A reason : Applying lotion between the toes is not recommended for individuals with diabetic neuropathy. Moisture can accumulate in these areas, creating an environment conducive to fungal infections. Instead, lotion should be applied to the tops and bottoms of the feet to keep the skin moisturized and prevent cracking, but the areas between the toes should be kept dry⁵.

Choice B reason : Wearing open-toed shoes is generally not advised for patients with diabetic neuropathy. Open-toed shoes can expose the feet to injuries, which can go unnoticed due to the loss of sensation associated with neuropathy. It's important for individuals with diabetic neuropathy to wear well-fitting, closed-toed shoes that protect the feet from external injuries⁵.

Choice C reason : Washing feet in hot water is unsafe for those with diabetic neuropathy because they may not be able to accurately gauge the temperature due to reduced sensation, leading to burns. The water temperature should be warm, and individuals should always test it with their hands or a thermometer before immersing their feet⁵.

Choice D reason : Walking barefoot is risky for individuals with diabetic neuropathy because they may not feel cuts, scrapes, or other injuries due to decreased sensation in their feet. These injuries can lead to infections and ulcers if not treated promptly. Therefore, it is crucial to avoid walking barefoot and to always wear protective footwear, even indoors⁵.