A nurse is caring for a school-age child who has appendicitis.
For which of the following findings should the nurse monitor as a manifestation of a perforated appendix and report to the provider?

The correct answer is: a. Displacement.

Choice A Reason: Displacement is a defense mechanism where a person redirects a negative emotion from its original source to a less threatening recipient. In the context of bipolar disorder, a client may displace anger or frustration about their condition or treatment onto the nurse, who is not the source of these feelings. This redirection can occur because the client might feel powerless or uncomfortable expressing these emotions towards their healthcare provider, who is the authority figure prescribing medication changes.

Choice B Reason: Splitting is often associated with borderline personality disorder rather than bipolar disorder. It involves viewing things in extremes—either all good or all bad—with no middle ground. While individuals with bipolar disorder can exhibit black-and-white thinking, especially during mood episodes, the behavior described does not indicate splitting, as it does not involve idealizing or devaluing the nurse or provider.

Choice C Reason: Sublimation is a mature defense mechanism where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior, often resulting in a long-term conversion of the initial impulse. For example, a person with aggressive tendencies might take up a sport that channels aggression in a socially acceptable way. The scenario provided does not suggest that the client is channeling their frustrations into a constructive activity.

Choice D Reason: Conversion involves the transfer of mental stress into physical symptoms. This defense mechanism is characteristic of conversion disorder, where psychological stress manifests as neurological symptoms like blindness, paralysis, or other sensory or motor symptoms without a medical cause. The client yelling at the nurse does not reflect a conversion of emotional distress into physical symptoms.

The correct answer is d. To cremate the client’s body.

Choice A reason: This choice is incorrect because Hinduism does not generally prohibit medical personnel from touching the deceased’s body. In fact, it is customary for family members to prepare the body for cremation, which may include washing and dressing.

Choice B reason: This statement is incorrect as there is no specific tradition in Hinduism that requires the family to stay with the body for 8 hours following death.

Choice C reason: This option is incorrect because Hinduism typically does not prescribe burial within 24 hours of death. While some religions have specific time frames for burial, Hinduism generally prefers cremation over burial.

Choice D reason: This is the correct choice. Cremation is preferred in Hinduism and is usually performed as soon as possible, traditionally by the next day. It is believed to release the soul and help in its onward journey.