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

Regression

Projection

Denial

Displacement

Answer and Explanation

The Correct Answer is C

A. Regression is reverting to earlier developmental behaviors (e.g., thumb-sucking under stress). The patient is not showing childlike behaviors.

B. Projection involves attributing one’s own unacceptable feelings to others. The patient is not blaming others for symptoms.

C. Denial is refusing to acknowledge a painful reality. Despite clear symptoms and diagnostic testing, the patient minimizes illness by attributing it to "just a stubborn chest cold."

D. Displacement is redirecting emotions onto a safer target (e.g., yelling at spouse instead of boss). Not evident here.

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Correct Answer is D

Explanation

A. Tranylcypromine sulfate (Parnate) is a monoamine oxidase inhibitor (MAOI) that carries a high risk of toxicity in overdose and is generally avoided in patients with a history of suicide attempts.

B. Amitriptyline (Elavil) is a tricyclic antidepressant (TCA), which can be lethal in overdose, making it unsafe for patients at high risk for suicide.

C. Desipramine (Norpramin) is also a TCA and poses a similar overdose risk as amitriptyline, so it is not preferred for suicidal patients.

D. Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI), which has a much lower lethality in overdose compared to TCAs or MAOIs, making it the preferred choice for patients with a history of suicidal behavior.

A. drink twice the usual dally amount of fluid. B. double the lithium dose if diarrhea or vomiting occurs. C. maintain normal salt and fluids in the diet. D. avoid eating aged cheese, processed meats, and red wine.

Correct Answer is C

Explanation

A. Patients do not need to double fluid intake, just maintain adequate hydration (2–3 L/day). Drinking twice the usual amount could lead to fluid overload or dilute sodium balance.

B. Lithium should never be doubled. In fact, vomiting and diarrhea increase risk of lithium toxicity, so the provider must be notified instead.

C. Lithium excretion is closely tied to sodium and fluid balance. A stable diet with normal salt and adequate fluid intake helps prevent fluctuations in lithium levels and reduces risk of toxicity.

D. Avoiding aged cheese, processed meats, and red wine is teaching for MAOI therapy (to prevent hypertensive crisis due to tyramine), not for lithium.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adult outpatient diagnosed with major depressive disorder has a history of several suicide attempts by overdose. Given this patient's history and diagnosis, which antidepressant medication would the nurse expect to be prescribed to this patient?

Correct Answer is D

Explanation

A health teaching plan for a patient taking lithium should include instructions to

Correct Answer is C

Explanation

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