A nurse is caring for a client who states, "I smoke because I have a lot of anxiety." The nurse should recognize the client's statement as which of the following defense mechanisms?

Projection

Sublimination

Rationalization

Dissociation

Answer and Explanation

The Correct Answer is C

A. Projection: Projection involves attributing one’s own undesirable feelings or thoughts onto others. This is not applicable here, as the client is not projecting their behavior onto someone else.

B. Sublimation: Sublimation is the process of channeling negative or unacceptable impulses into socially acceptable activities. Smoking due to anxiety is not an example of channeling impulses into a productive or acceptable activity.

C. Rationalization: Rationalization is a defense mechanism where a person justifies or makes excuses for their behavior or feelings. In this case, the client is justifying smoking as a way to manage anxiety, which is a classic example of rationalization.

D. Dissociation: Dissociation involves a detachment from reality or a separation of thoughts, identity, or consciousness, typically as a coping mechanism in response to trauma or stress. It is not applicable in this situation, where the client is not detaching from reality.

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Correct Answer is A

Explanation

A. "Would you like to discuss other treatment options with your provider?": This response invites the client to express concerns and explore alternative treatments. It shows respect for their preferences and promotes a collaborative decision-making process.

B. "Regular monitoring is not difficult and will ensure that you remain healthy.": This response downplays the client’s concerns and could be seen as dismissive. It focuses more on the ease of monitoring than addressing the client’s discomfort.

C. "Your provider wants you to take this medication.": Using authority to justify medication may cause the client to feel coerced rather than involved in their treatment. This doesn’t address their concerns and may erode trust.

D. "Why don't you want to undergo monitoring?": Asking why could put the client on the defensive and may make them feel judged. It doesn’t foster open communication or understanding of the client’s concerns.

A. "Do you snore loudly?" B. "What time do you go to bed?" C. "How often do you have trouble sleeping?" D. "Do you fall asleep unexpectedly?"

Correct Answer is A

Explanation

A. "Do you snore loudly?": Loud snoring is a common symptom of sleep apnea, particularly obstructive sleep apnea. The nurse should inquire about snoring, as it may indicate airway obstruction during sleep, a key feature of the condition.

B. "What time do you go to bed?": While bedtime habits are relevant to sleep hygiene, the specific timing of going to bed is not as directly related to diagnosing sleep apnea. Other questions, such as snoring or breathing patterns, are more relevant for this assessment.

C. "How often do you have trouble sleeping?": Trouble sleeping can be a symptom of various sleep disorders, but it is not specific to sleep apnea. The nurse should focus on symptoms like snoring, choking, or stopping breathing during sleep, which are more indicative of sleep apnea.

D. "Do you fall asleep unexpectedly?": Falling asleep unexpectedly may suggest excessive daytime sleepiness, which can be a result of sleep apnea. However, snoring is a more direct and common symptom of sleep apnea that should be prioritized in the initial assessment.

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A nurse is caring for a client who states, "I smoke because I have a lot of anxiety." The nurse should recognize the client's statement as which of the following defense mechanisms?

Nursing Test Bank

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