A nurse is leading a therapy session for a group of adolescent clients. Which of the following statements should the nurse identify as an adaptive use of ego defense mechanisms?
"Since injuring my knee. I've decided to become the team manager."
"Since my mom died, I focus all my attention on my grades."
“I didn't tell the teacher about the bullying because it wouldn't have changed anything."
"I'm not even going to think about writing that thesis paper until after prom."
The Correct Answer is A
A. "Since injuring my knee, I've decided to become the team manager."
Option A represents an adaptive use of the ego defense mechanism known as sublimation. Sublimation is a process in which a person channels potentially negative or harmful impulses or feelings into more socially acceptable and constructive activities. In this case, the adolescent with the injured knee is using the opportunity to become the team manager, which is a positive and constructive way to stay engaged with the team despite the setback of the injury.
B. "Since my mom died, I focus all my attention on my grades."
This is an example of reaction formation, a defense mechanism where someone overemphasizes the opposite of their true feelings. In this case, the individual might be hiding or avoiding their grief by focusing on grades.
C. "I didn't tell the teacher about the bullying because it wouldn't have changed anything."
This is an example of rationalization, where the individual provides a logical-sounding but potentially inaccurate explanation for their actions. It can be a defense mechanism to justify or make more acceptable one's choices.
D. "I'm not even going to think about writing that thesis paper until after prom."
This is an example of procrastination or avoidance, which is not an ego defense mechanism but a coping or time-management strategy. It doesn't represent an adaptive use of a defense mechanism in this context.
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Correct Answer is C
Explanation
A. "What have you done to change your situation?"
This response can come off as accusatory and might make the client feel judged. It's not the most therapeutic response in this situation.
B. "You should remove yourself from this situation now."
While removing oneself from a harmful situation is generally good advice, it might not be practical or safe in the heat of the moment. Moreover, this response doesn't address the underlying emotional distress the client is expressing.
C. “Are you thinking about harming yourself?"
This response directly assesses the client's suicidal ideation. It's essential to ask direct questions about self-harm when a person expresses feelings of hopelessness, as it provides an opportunity for the client to talk about their thoughts and feelings and for the nurse to assess the level of risk accurately.
D. “We will help get you through this. You'll be fine."
While offering support and reassurance is essential, it doesn't directly address the immediate concern of potential suicidal thoughts. The nurse should assess the client's safety first before providing reassurance.
Correct Answer is A
Explanation
A. "Reassure staff members that the debriefing is confidential."
This is an appropriate first step. Ensuring confidentiality creates a safe environment where individuals feel comfortable sharing their experiences and emotions.
B. "Have staff members discuss their involvement in the event."
This can be a part of the debriefing process, but it might not be the first step. Generally, individuals are given the option to share their experiences, but they should not be forced to do so. Some might not be ready to talk about their involvement immediately.
C. "Ask staff members to describe their most traumatic memories of the event."
This might be too intrusive as a first step. It's important to approach discussions about specific traumatic memories with caution and only when individuals are comfortable sharing.
D. "Provide stress-management exercises to the staff members."
This could be a helpful step after ensuring confidentiality and allowing individuals the opportunity to express their feelings. Stress-management exercises can provide valuable coping strategies.
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