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?

Choice A rationale:

Focuses on the nurse's feelings rather than the client's needs. This response may make the client feel guilty or defensive, and it does not address the underlying cause of their anger or frustration.

Shuts down communication. Saying "That's a hurtful thing to say" can signal to the client that the nurse is not open to hearing their concerns, which can hinder the development of trust and rapport.

Fails to acknowledge the client's pain. The client is in a vulnerable position, experiencing both physical and emotional pain. This response does not recognize the validity of their experience, which can further alienate them.

Choice B rationale:

Invites the client to share their perspective. By saying "Tell me more about that," the nurse demonstrates a willingness to listen and understand the client's concerns. This can help to build trust and rapport, and it can provide valuable insights into the client's experience.

Promotes exploration of feelings. Allowing the client to express their feelings can help them to process their emotions and to feel more understood. This can lead to a greater sense of control and empowerment, which can be beneficial for their overall coping and healing.

Gathers information to tailor care. By listening to the client's concerns, the nurse can gain a better understanding of their specific needs and preferences. This information can then be used to adjust the plan of care to better meet the client's individual needs.

Choice C rationale:

Dismisses the client's feelings. Saying "Well, that's your opinion" minimizes the client's experience and sends the message that their feelings are not important. This can damage the therapeutic relationship and make the client feel even more isolated and unsupported.

Fails to address the underlying issue. This response does not attempt to explore the reasons for the client's anger or frustration, which means that the problem is likely to continue.

Choice D rationale:

Sounds accusatory and confrontational. Asking "Why would you say such a thing?" can put the client on the defensive and make them feel like they have to justify their feelings. This can hinder open communication and make it more difficult to address the root of the problem.

May make the client feel judged or criticized. This response can come across as judgmental and uncaring, which can further alienate the client and damage the therapeutic relationship.

Choice A rationale:

This response indicates anger, not denial. The client is expressing anger towards the doctor and their perceived lack of competence. While anger can be a component of the grief process, it does not specifically align with the denial phase, which is characterized by a refusal to accept the reality of a situation.

Choice B rationale:

This response indicates fatigue or depression, not denial. The client is acknowledging their physical and emotional state but is not expressing disbelief or refusal to accept their diagnosis.

Choice C rationale:

This response clearly demonstrates denial. The client is minimizing the severity of their diagnosis and attributing the doctor's statements to an ulterior motive. This is a classic example of denial, as it involves a distortion of reality to avoid facing a painful truth.

Choice D rationale:

This response indicates acceptance, not denial. The client is acknowledging the reality of their situation and expressing gratitude for the care they have received.