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 C

Explanation

Choice A reason: Prolonged silences may cause withdrawal in some patients, as anxiety from serotonin or GABA imbalances can heighten discomfort. However, this does not guide silence’s use. Silence is therapeutic when timed appropriately, not avoided due to potential withdrawal, making this principle incorrect.

Choice B reason: Nurses breaking silences assumes discomfort, ignoring therapeutic benefits. Silence allows processing, potentially calming amygdala hyperactivity in anxiety. The nurse’s role is to use silence strategically, not to interrupt it routinely, making this principle misaligned with effective interview techniques.

Choice C reason: Silence facilitates reflection, allowing patients to process emotions, reducing stress via hypothalamic calming. In disorders like depression, it supports cognitive restructuring by giving time to integrate thoughts. This principle guides therapeutic silence, aligning with neurobiological benefits of reflective pauses in interviews.

Choice D reason: Silence does not inherently confirm understanding. It may allow emotional processing, but assuming it signals comprehension risks miscommunication. In conditions like anxiety, silence supports reflection, not validation, making this principle less accurate than reflection for guiding its therapeutic use.

A. “Mental illness can be evidence of a brain disorder.” B. “Many mental illnesses are a result of genetic predisposition.” C. “Even children may have diagnosable mental health conditions.” D. “Mental illness is a result of the breakdown of the American family.”

Correct Answer is D

Explanation

Choice A reason: Linking mental illness to brain disorders, like dopamine imbalances in schizophrenia, is factual and reduces stigma by emphasizing neurobiological causes. This aligns with scientific understanding, not perpetuating blame or stereotypes, making it an incorrect choice for reflecting stigma.

Choice B reason: Genetic predisposition, such as serotonin transporter gene variations, is a scientific explanation for mental illness. This reduces stigma by highlighting biological causes, not personal failings, aligning with evidence-based understanding and making it an incorrect choice for stigmatizing mental illness.

Choice C reason: Recognizing mental illness in children, like ADHD with dopamine deficits, normalizes early diagnosis and treatment. This factual statement reduces stigma by acknowledging neurobiological conditions across ages, making it an incorrect choice for reflecting stigmatizing attitudes toward mental illness.

Choice D reason: Blaming mental illness on family breakdown ignores neurobiological causes, like serotonin or dopamine imbalances, and perpetuates stigma by implying personal or social failure. This judgmental view misrepresents scientific evidence, making it the correct choice for reflecting stigmatizing attitudes toward mental illness.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which principle should guide the nurse in determining when to use silence during a patient interview?

Correct Answer is C

Explanation

Which statement most clearly reflects the stigma of mental illness?

Correct Answer is D

Explanation

Your patient sometimes forgets to eat. In which part of the nursing care plan would the nurse expect to find this statement: “Offer snacks and finger foods frequently”?

Which statement shows a nurse has empathy for a patient who made a suicide attempt?

A patient presents with anxiety, increased heart rate, and fear. The nurse suspects the activation of which neurotransmitter?

A nursing student says, “Little of what takes place on the behavioral health unit seems to be theory-based.” A nurse educates the student by identifying which is a common use of Sullivan’s theory on the inpatient psychiatric unit?

On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?

A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for a patient presenting with what characteristic?

A nurse explains to a nursing student how the therapeutic relationship differs from a social relationship. What is the best explanation for the therapeutic relationship between the nurse and patient?