A nurse is conducting a group therapy session for several clients. The group is laughing at a joke one of the clients told, when a client who is schizophrenic jumps up and runs out of the room yelling. "You are all making fun of me!" The nurse should identify this behavior as which of the following characteristics of schizophrenia?

A. Suppression: Suppression involves consciously pushing down or ignoring thoughts, feelings, or memories that are perceived as unacceptable or distressing. In this scenario, the client is not consciously trying to push down or ignore their behavior; instead, they are explaining their actions using a defense mechanism.

B. Reaction-formation: Reaction-formation occurs when an individual expresses feelings or behaviors that are the opposite of their true feelings or desires. In this case, the client's statement does not involve expressing the opposite of their true feelings. Instead, they are rationalizing their behavior.

C. Compensation: Compensation involves attempting to overcome feelings of inadequacy or failure in one area by excelling in another area. The client's statement does not suggest that they are compensating for anything; rather, they are explaining their behavior through a defense mechanism.

D. Rationalization: Rationalization involves providing logical or socially acceptable reasons for behavior that are not the true reasons. In this scenario, the client is rationalizing their behavior by attributing it to external factors, such as their boss's influence, rather than acknowledging their own responsibility for their actions. This defense mechanism allows the client to avoid facing the underlying issue of alcohol abuse by providing a seemingly reasonable explanation for their behavior.

A. Provide a structured activity schedule for the client: While providing a structured activity schedule can be beneficial for clients with OCD, it may not be the first action the nurse should take. Before implementing such a schedule, it is essential to understand the underlying factors contributing to the client's ritualistic behaviors.

B. Identify precipitating factors for ritualistic behaviors: This is the first action the nurse should take when caring for a client with OCD. By identifying the triggers or precipitating factors that lead to the client's ritualistic behaviors, the nurse can develop a targeted plan of care to address these specific triggers and help the client manage their symptoms more effectively.

C. Instruct the client on relaxation techniques for use when anxiety increases: While relaxation techniques can be helpful for managing anxiety associated with OCD, identifying precipitating factors should be addressed first to understand the specific triggers contributing to the client's anxiety and ritualistic behaviors.

D. Discuss alternative coping strategies with the client: Exploring alternative coping strategies is an important aspect of caring for clients with OCD, but it should come after identifying precipitating factors. Once triggers are identified, the nurse and client can collaboratively develop and implement alternative coping strategies tailored to the client's specific needs and triggers.