Nokea
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?
- A. Displacement
- B. Regression
- C. Projection
- D. Denial
Correct Answer: D
Rationale: Denial is an unconscious blocking of threatening or painful information or feelings. Regression involves using behaviors appropriate at an earlier stage of psychosexual development. Displacement shifts feelings to a more neutral person or object. Projection attributes one's own unacceptable thoughts or feelings to another.
You may also like to solve these questions
Two staff nurses applied for promotion to nurse manager. Initially, the nurse not promoted had feelings of loss but then became supportive of the new manager by helping make the transition smooth and encouraging others. Which term best describes the nurse's response?
- A. Altruism
- B. Sublimation
- C. Suppression
- D. Passive aggression
Correct Answer: A
Rationale: Altruism is the mechanism by which an individual deals with emotional conflict by meeting the needs of others and vicariously receiving gratification from the responses of others. The nurse's reaction is conscious, not unconscious. No evidence of aggression is exhibited, and no evidence of conscious denial of the situation exists. Passive aggression occurs when an individual deals with emotional conflict by indirectly and unassertively expressing aggression toward others.
A patient with a mass in the left upper lobe of the lung is scheduled for a biopsy. The patient has difficulty understanding the nurse's comments and asks, 'What are they going to do?' Assessment findings on the patient include a tremulous voice, respirations 28 breaths per minute, and pulse rate 110 beats/min. What is the patient's level of anxiety?
- A. Mild
- B. Moderate
- C. Severe
- D. Panic
Correct Answer: B
Rationale: Moderate anxiety causes the individual to grasp less information and reduces his or her problem-solving ability to a less-than-optimal level. Mild anxiety heightens attention and enhances problem-solving abilities. Severe anxiety causes great reduction in the perceptual field. Panic-level anxiety results in disorganized behavior.
A patient has the nursing diagnosis anxiety as evidenced by an inability to control compulsive cleaning. Which phrase referring to the likely trigger correctly completes the etiological portion of the diagnosis?
- A. Ensuring the health of household members
- B. Attempting to avoid interactions with others
- C. Having persistent thoughts about bacteria, germs, and dirt
- D. Needing approval for cleanliness from friends and family
Correct Answer: C
Rationale: Many compulsive rituals accompany obsessive thoughts. The patient uses these rituals to relieve anxiety. Unfortunately, the anxiety relief is short lived, and the patient must frequently repeat the ritual. The other options are unrelated to the dynamics of compulsive behavior.
A patient checks and rechecks electrical cords related to an obsessive thought that the house may burn down. The nurse and patient explore the likelihood of an actual fire. The patient states that a house fire is not likely. This counseling demonstrates the principles of which cognitive-based therapy?
- A. Flooding
- B. Desensitization
- C. Controlled relaxation
- D. Thought restructuring
Correct Answer: D
Rationale: Cognitive restructuring involves the patient in testing automatic thoughts and drawing new conclusions. Desensitization involves a graduated exposure to a feared object. Relaxation training teaches the patient to produce the effects of calmness. Flooding exposes the patient to a large number of undesirable stimuli in an effort to extinguish the anxiety response.
A patient performs ritualistic hand washing. What should the nurse do to help the patient develop more effective coping strategies?
- A. Allow the patient to set a hand-washing schedule.
- B. Encourage the patient to participate in social activities.
- C. Encourage the patient to discuss hand-washing routines.
- D. Focus on the patient's symptoms rather than on the patient.
Correct Answer: B
Rationale: Because patients diagnosed with obsessive-compulsive disorder become overly involved in rituals, promoting involvement with other people and activities is necessary to improve the patient's coping strategies. Daily activities prevent the constant focus on anxiety and its symptoms. The other interventions focus on the compulsive symptom.