A nurse is counseling a client for the management of anxiety. The client is consistently late for appointments and ignores household chores. The client states, "I'm just too stressed. I need someone to take care of me." The nurse identifies this behavior as an example of which of the following defense mechanisms?

Repression

Introjection

Dissociation

Regression

Answer and Explanation

The Correct Answer is D

A. Repression: Repression involves unconsciously pushing unwanted thoughts, memories, or feelings out of conscious awareness. It involves burying distressing emotions or memories deep in the unconscious mind to avoid dealing with them consciously. In this scenario, the client's behavior does not suggest the repression of any specific thoughts or memories but rather a coping mechanism related to their current stress and anxiety.

B. Introjection: Introjection occurs when an individual internalizes the values, beliefs, or attitudes of others as if they were their own. It involves incorporating external standards or influences into one's own identity. While introjection may contribute to the client's behavior indirectly by influencing their beliefs about needing external support, the primary defense mechanism at play in this scenario is regression.

C. Dissociation: Dissociation involves a disruption in the integration of consciousness, memory, identity, or perception of the environment. It often manifests as a detachment from reality or a sense of being disconnected from oneself or the surrounding environment. While dissociation may occur in response to severe stress or trauma, it typically involves more extreme symptoms than those described by the client in this scenario.

D. Regression: Regression involves reverting to earlier, less mature behaviors or stages of development in response to stress or anxiety. It reflects a retreat to a more comfortable or familiar state in an attempt to cope with overwhelming emotions or situations. In this scenario, the client's statement about needing someone to take care of them suggests a desire to return to a state of dependency, which is characteristic of regression as a defense mechanism.

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Correct Answer is C

Explanation

A. Decreased auditory and visual acuity: Decreased auditory and visual acuity are not typically associated with primary dementia. While sensory impairments may occur with aging, they are not direct manifestations of dementia.

B. Decreased display of emotions: While individuals with dementia may experience changes in emotional expression, such as mood swings or emotional lability, a decreased display of emotions is not a universal manifestation. Some individuals may exhibit heightened emotional responses or become more emotionally labile as the disease progresses.

C. Forgetfulness gradually progressing to disorientation: This is the correct choice. Forgetfulness is often one of the initial signs of dementia, and it typically progresses to more severe cognitive impairments, including disorientation to time, place, and person. As dementia advances, individuals may become increasingly confused about their surroundings and lose track of time and events.

D. Personality traits that are opposite of original traits: While some changes in personality and behavior may occur in individuals with dementia, such as agitation, irritability, or apathy, personality traits that are opposite of the original traits are not necessarily characteristic of primary dementia. Personality changes in dementia are often more related to cognitive decline and impairment rather than a complete reversal of personality traits.

A. A semi-private room with a roommate who has a similar diagnosis B. A private room close to the nursing station C. A private room in a quiet location on the unit D. A seclusion room until the client's activity level becomes more subdued

Correct Answer is B

Explanation

A. A semi-private room with a roommate who has a similar diagnosis. Placing a client experiencing a manic episode in a semi-private room with another client who also has a similar diagnosis could potentially exacerbate symptoms or lead to conflict. Manic clients may have increased energy levels, impulsivity, and decreased need for sleep, which could disrupt the roommate's rest and compromise their safety.

B. A private room close to the nursing station. Assigning a private room close to the nursing station is the most appropriate option for a client in the manic phase of bipolar disorder. This allows for closer monitoring and supervision by nursing staff, as well as easier access for interventions and assistance when needed. It also helps to minimize stimulation and provide a more controlled environment for the client.

C. A private room in a quiet location on the unit. While a quiet location may be beneficial for some clients, a private room close to the nursing station offers better access to supervision and support from staff, which is particularly important for clients experiencing mania. Additionally, a quiet location may not always be feasible in a busy psychiatric unit.

D. A seclusion room until the client's activity level becomes more subdued. Using a seclusion room should only be considered as a last resort and when absolutely necessary to ensure the safety of the client and others. It should not be the first choice for a client in the manic phase of bipolar disorder. Placing the client in seclusion may further escalate agitation and increase feelings of isolation and distress.

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Naxlex Comprehensive Predictor Exams

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?

Correct Answer is C

Explanation

A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client?

Correct Answer is B

Explanation

A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanisms?

A nurse is preparing to administer a vaccine into the deltoid muscle of a preschooler. Which of the following actions should the nurse take?

A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development?

A nurse is caring for a newborn whose mother voices concerns about sudden Infant death syndrome (SIDS). The nurse should include which of the following statements in a discussion with the mother?

A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan?

A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?

A nurse is caring for a 2-month-old infant who is postoperative following repair of a cleft lip and palate. The provider prescribes restraints. The nurse should apply which of the following types of restraints for this infant?

A nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings should the nurse expect?