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. Monitor the client closely to prevent self-mutilation: This action is not typically associated with dependent personality disorder. Dependent personality disorder is characterized by an excessive need to be taken care of, leading to submissive and clinging behaviors, rather than self-mutilation.

B. Give positive feedback when the client is assertive with staff or clients: While it is important to encourage and reinforce assertive behaviors, giving positive feedback alone may not be sufficient to address the underlying issues associated with dependent personality disorder. It's essential to provide comprehensive care that addresses the client's dependency needs and promotes healthy assertiveness.

C. Set limits to prevent exploitation of other clients: Clients with dependent personality disorder may exhibit behaviors that involve relying excessively on others and seeking caretaking from them. Setting limits helps prevent these clients from exploiting or overly burdening others with their needs, promoting boundaries and accountability within the therapeutic environment.

D. Discourage flamboyant or seductive behaviors: Flamboyant or seductive behaviors are not typical characteristics of dependent personality disorder. These behaviors are more commonly associated with other personality disorders, such as histrionic or borderline personality disorder. In dependent personality disorder, the focus is more on an excessive need for support and reassurance rather than attention-seeking behaviors.

A. Feed the infant with a spoon for 48 hr. B. Apply and release elbow restraints every hour. C. Keep the infant supine D. Suction the mouth with an oral suction tube.

Correct Answer is B

Explanation

A. Feed the infant with a spoon for 48 hr.

Following cleft palate repair, infants may need special feeding techniques to minimize the risk of injury to the surgical site. Feeding with a spoon is a gentle method that reduces the risk of trauma to the repaired palate. However, it is typically recommended for a longer duration than 48 hours, often until the surgical site is fully healed and the healthcare provider provides further instructions. Therefore, this option is not entirely accurate.

B. Apply and release elbow restraints every hour.

Elbow restraints are commonly used postoperatively in infants to prevent them from inadvertently touching or scratching the surgical site. Releasing and reapplying the restraints every hour helps prevent skin breakdown and ensures adequate circulation to the extremities. This intervention helps maintain the integrity of the surgical repair and reduces the risk of complications. Therefore, this is an appropriate intervention for an infant post cleft palate repair.

C. Keep the infant supine

While keeping the infant supine may be necessary to prevent aspiration and promote comfort, it is not the primary intervention to address the surgical repair of the cleft palate. Positioning recommendations may vary based on the surgeon's preferences and the infant's specific needs, but supine positioning alone does not address the prevention of trauma to the surgical site.

D. Suction the mouth with an oral suction tube.

Suctioning the mouth with an oral suction tube may be indicated to maintain airway patency and remove secretions, especially if the infant has difficulty swallowing or clearing oral secretions effectively. However, it is not typically specified as a routine intervention following cleft palate repair unless there are specific concerns about airway compromise or excessive secretions. Therefore, while it may be necessary in some cases, it is not a standard intervention for all infants post cleft palate repair.

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

A nurse is planning care for a 10-month-old infant who is 8 hr postoperative following cleft palate repair. Which of the following interventions should the nurse include in the infant's plan of care?

Correct Answer is B

Explanation

A parent tells a nurse that her toddler drinks a quart of milk a day and has a poor appetite for solid foods. The nurse should explain that the toddler is at risk for which of the following disorders?

A nurse is caring for a toddler who has acute laryngotracheobonchitis after a repair of an intussusception. Which of the indicates that the treatment has been effective?

A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches, the client states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following responses should the nurse make?

A nurse is caring for a 4-year-old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection?

A parent of a toddler asks a nurse at a well-child visit how the child's frequent temper tantrums can best be handled. Which of the following actions should the nurse suggest to the parent?

A nurse is assessing a toddler who has suspected lead poisoning. Which of the following findings should the nurse expect the client to manifest with acute lead poisoning?

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 caring for a 6-week-old infant who has a pyloric stenosis. Which of the following clinical manifestations should the nurse expect?