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A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks for a bed bath, and makes many demands of the nurses. He also yells that they are lazy and incompetent. The nurse recognizes this behavior as which of the following defense mechanisms?
- A. Introjection
- B. Projection
- C. Rationalization
- D. Reaction formation
Correct Answer: B
Rationale: Projection involves attributing one's own unacceptable thoughts or feelings, such as laziness, to others, as seen in the client's accusations toward the nurses.
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A patient states, 'I hate spending time with my family. They're always on my back about something. I won't do anything they ask me to do.' Which response by the nurse reflects a behavioral perspective?
- A. Let's play like I'm your parent, and we'll practice some better ways to communicate that won't result in an argument.
- B. Some medicines really help with anger. Are you interested in talking to your physician about starting you on something?
- C. That's probably your way of getting back at them for being strict with you when you were younger.
- D. If you agree to start doing what your parents request, then they have agreed to respect your privacy more.
Correct Answer: D
Rationale: A behavioral perspective focuses on observable behaviors and uses rewards or consequences to modify them, as in negotiating compliance for privacy.
A teenaged client is playing a video game when the nurse says it is time to go to sleep. The teen says angrily, 'You sound just like my mother at home!' and continues to play the video game. The nurse understands that this statement likely indicates
- A. The need of firm limit-setting
- B. Transference
- C. Ineffective parenting
- D. A personality disorder
Correct Answer: B
Rationale: Transference occurs when a client projects attitudes or feelings from past relationships, such as those with a parent, onto the therapist. The teen's reaction reflects this dynamic, not necessarily ineffective parenting, a disorder, or the need for limit-setting.
A nurse is meeting with a crisis support group. In efforts to help patients identify with one another, the nurse explains which of the following about the crisis experience?
- A. Even happy events can cause a crisis if the stress is overwhelming.
- B. Only people who have unfortunate life events will experience a crisis.
- C. A person has no control over how a crisis will affect him or her.
- D. People can prevent all crises if they develop good coping skills early.
Correct Answer: A
Rationale: Crises can arise from both positive and negative events, like marriage or loss, when stress overwhelms coping abilities. Not all crises stem from negative events, individuals have some control through coping, and not all crises can be prevented.
A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Erikson's developmental stages?
- A. Identity versus role confusion
- B. Industry versus inferiority
- C. Integrity versus despair
- D. Generativity versus stagnation
Correct Answer: C
Rationale: Erikson's integrity vs. despair stage, occurring in later adulthood, involves reflecting on one's life and future, as described in the client's behavior.
A student nurse attends a self-help group as part of a class assignment. While there the student recognizes a family friend. Upon returning home, the student talks about the experience with the family. The student's actions can be described as
- A. Appropriate, persons familiar with group members are allowed self-help group membership.
- B. Appropriate; self-help groups are not professional and therefore are open to public knowledge.
- C. Inappropriate; most self-help groups have a rule of confidentiality.
- D. Inappropriate; the student should not have been allowed to attend the group.
Correct Answer: C
Rationale: Most self-help groups, like 12-step programs, maintain confidentiality, making it inappropriate to discuss attendees or content outside the group.