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: Refusal of medication due to paranoia is not typically associated with conversion disorder. Paranoia is more commonly seen in disorders such as schizophrenia or paranoid personality disorder.

Choice B rationale: Preoccupation with manifestations of various illnesses is a characteristic of somatic symptom disorder, not conversion disorder. In somatic symptom disorder, individuals are excessively worried about having a serious illness, despite having no or only mild symptoms.

Choice C rationale: Frequent manic episodes are a hallmark of bipolar disorder, not conversion disorder. Manic episodes involve periods of extreme high energy or mood.

Choice D rationale: Conversion disorder, also known as functional neurological symptom disorder, is characterized by the presence of neurological symptoms, such as the loss of a sensory or motor function, that cannot be explained by medical evaluation. Symptoms can include seizures, weakness or paralysis, or reduced input from one or more senses. Therefore, an involuntary loss of a sensory function or a motor function with no underlying neurologic pathology is an expected finding in a client diagnosed with conversion disorder.

Choice A rationale:

Antipsychotic medications are a class of drugs commonly used to treat schizophrenia and other psychotic disorders. They work by blocking dopamine receptors in the brain. However, dopamine is also involved in motor control, and blocking its receptors can lead to extrapyramidal symptoms (EPS).

EPS are a group of movement disorders that can be caused by antipsychotic medications. They include: Akathisia: A feeling of restlessness and an inability to sit still.

Dystonia: Involuntary muscle contractions that can cause twisting or spasms.

Parkinsonism: Symptoms similar to Parkinson's disease, such as tremor, rigidity, and slowness of movement. Tardive dyskinesia: Involuntary, repetitive movements of the face, tongue, or other body parts.

The risk of developing EPS is higher with older antipsychotic medications, such as haloperidol and chlorpromazine. Newer antipsychotic medications, such as risperidone and olanzapine, are less likely to cause EPS, but they can still occur.

Clients who are taking antipsychotic medications should be monitored for EPS. If EPS develop, the medication may need to be changed or the dose reduced.

Choice B rationale:

Enzymes are not known to cause EPS. They are used to treat pancreatitis by helping the body to digest food.

Choice C rationale:

Insulin is not known to cause EPS. It is used to treat type 2 diabetes mellitus by helping the body to control blood sugar levels.

Choice D rationale:

Iron supplements are not known to cause EPS. They are often taken by pregnant women to prevent iron deficiency anemia.