A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?

Projection

Regression

Denial

Displacement

Answer and Explanation

The Correct Answer is C

Choice A reason: Projection involves attributing one’s issues to others, not ignoring symptoms. The patient’s dismissal of serious symptoms, like weight loss, suggests denial, not projection. These symptoms may indicate physiological issues, not psychological attribution, making projection incorrect for this defense mechanism.

Choice B reason: Regression involves reverting to childish behaviors, not ignoring symptoms. The patient’s claim of a minor cold despite weight loss and fatigue reflects denial, not regression. These symptoms suggest a serious condition, not immature coping, making this an incorrect defense mechanism.

Choice C reason: Denial involves refusing to acknowledge serious symptoms, like weight loss and fatigue, which may indicate a medical condition. By attributing them to a minor cold, the patient avoids reality, a common defense in stress-related cortisol spikes, making this the correct mechanism.

Choice D reason: Displacement redirects emotions to another target, not ignoring symptoms. The patient’s minimization of serious health issues, like fatigue, reflects denial, not redirected feelings. This mechanism is unrelated to dismissing physical symptoms, making it incorrect for the described behavior.

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Correct Answer is D

Explanation

Choice A reason: Canceling discharge overrides patient autonomy and recovery progress. Stabilized schizophrenia, managed with antipsychotics targeting dopamine, supports discharge with adherence. This action disregards the patient’s rights and neurobiological stabilization, making it an inappropriate advocacy response.

Choice B reason: Notifying security dismisses family concerns and escalates unnecessarily. Schizophrenia management relies on medication adherence, not coercion. This approach ignores patient rights and family education needs, failing to address neurobiological treatment principles, making it incorrect for advocacy.

Choice C reason: Transferring to long-term care assumes ongoing instability, ignoring current stabilization. Antipsychotics correct dopamine imbalances, supporting outpatient management. This undermines patient autonomy and recovery potential, making it an inappropriate advocacy action for a stabilized patient.

Choice D reason: Explaining medication adherence promotes patient autonomy and recovery. Antipsychotics reduce dopamine-driven hallucinations, ensuring symptom control. Educating the family empowers support for adherence, aligning with patient rights and neurobiological treatment principles, making this the correct advocacy response.

A. The policies do not absolve an individual nurse of the responsibility to practice according to professional standards of nursing care B. In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises C. Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care D. Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted

Correct Answer is A

Explanation

Choice A reason: Nurses must adhere to professional standards, ensuring safe care despite substandard policies. Restraint use, for example, must minimize harm and respect patient dignity, regardless of policy. This aligns with ethical principles and evidence-based practices for managing agitation linked to neurotransmitter imbalances, upholding nurse accountability.

Choice B reason: Leaving the premises after informing a supervisor abandons patients, violating ethical duties. Professional standards require nurses to advocate for safe practices, like appropriate restraint use for dopamine-driven agitation, within the system. This option is impractical and neglects patient care responsibilities, making it incorrect.

Choice C reason: Agency policies do not override professional standards. Nurses are accountable to evidence-based practices, ensuring interventions like restraints for severe agitation are safe and ethical. Policies may guide but cannot excuse deviations from standards addressing neurobiological safety needs, making this option scientifically and ethically incorrect.

Choice D reason: Judicial interpretation varies, but nursing practice is guided by professional standards, not unpredictable legal outcomes. Standards ensure safe, ethical care, like minimizing restraint use for serotonin-related agitation, regardless of policy or judicial variability. This option is irrelevant to guiding daily nursing practice.

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A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?

Correct Answer is A

Explanation

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