A nurse is discussing obesity with a client who has a BMI of 31. Which of the following comments by the client indicates the use of rationalization as a defense mechanism?

"I know you don't like me because of my weight."

"I have lots of health risks from being obese."

"I'm not really that much overweight."

"I can't help being overweight because it's in my genes."

Answer and Explanation

The Correct Answer is D

A. "I know you don't like me because of my weight.": This reflects projection, attributing the client’s own feelings or insecurities onto someone else. It does not show rationalization, as the client is focusing on perceived judgment rather than providing a reason to justify behavior.

B. "I have lots of health risks from being obese.": This demonstrates insight and acknowledgment of the health consequences of obesity. It does not reflect a defense mechanism, as the client is objectively recognizing risk factors rather than justifying behavior.

C. "I'm not really that much overweight.": This statement indicates denial, minimizing or refusing to accept the reality of the situation. It does not involve rationalizing a reason for the weight; it simply avoids acknowledging the problem.

D. "I can't help being overweight because it's in my genes.": This is an example of rationalization, where the client provides a socially acceptable or logical reason to justify behavior or circumstances. The client attributes obesity to genetics to avoid personal responsibility or feelings of guilt, which is characteristic of rationalization.

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Correct Answer is C

Explanation

A. "I was able to pay my bills last month, but this month, I fell behind.": Difficulty managing finances can indicate functional impairment, but it is nonspecific and could occur during depressive episodes or life stressors rather than mania.

B. "I've been crying a lot in the past 3 days because my cat died.": Persistent crying and sadness reflect depressive symptoms and situational grief rather than the elevated or irritable mood, increased energy, and hyperactivity seen in mania.

C. "I haven't been able to stop talking for the past couple of days.": Pressured speech and excessive talking are hallmark manifestations of the manic phase of bipolar disorder. This indicates heightened energy, distractibility, and reduced need for sleep associated with mania.

D. "My family says I'm thinking clearly now that I'm taking my medication.": Improved cognition and stability suggest effective management of symptoms, possibly after treatment for mania or depression, but it does not indicate current manic behavior.

A. Bring a security guard whenever approaching the client. B. Use a calm, clear tone when speaking to the client. C. Encourage the client to participate in a board game. D. Touch the client on the shoulder to console them.

Correct Answer is B

Explanation

A. Bring a security guard whenever approaching the client: Involving security unnecessarily can escalate tension and reinforce hostile behavior. Safety is important, but this intervention should be reserved for situations where the client poses an immediate physical threat.

B. Use a calm, clear tone when speaking to the client: Maintaining a calm, clear, and neutral tone helps de-escalate hostility and reduces the likelihood of verbal or physical aggression. Clear communication also sets boundaries while promoting a therapeutic environment for clients with schizophrenia.

C. Encourage the client to participate in a board game: While engaging in structured activities can be beneficial for socialization and distraction, this intervention does not directly address the immediate hostile outbursts or prevent escalation. It is more of a supportive measure than a priority intervention.

D. Touch the client on the shoulder to console them: Physical touch can be misinterpreted by clients with schizophrenia, potentially triggering anxiety, agitation, or further hostility. Nonverbal boundaries should be maintained unless the client explicitly consents to touch in a therapeutic context.

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A nurse is discussing obesity with a client who has a BMI of 31. Which of the following comments by the client indicates the use of rationalization as a defense mechanism?

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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