A fourth-grade student teases and makes jokes about a cute girl in his class. This behavior should be identified by a professional as indicative of which defense mechanism?
- A. Displacement
- B. Projection
- C. Reaction formation
- D. Sublimation
Correct Answer: C
Rationale: The professional should identify that the student is using reaction formation as a defense mechanism. Reaction formation involves expressing opposite thoughts or behaviors to prevent undesirable thoughts from being expressed. In this scenario, the student's teasing and joking behavior towards the girl can be seen as a way to cover up or mask his true feelings or desires towards her. Displacement involves redirecting emotions from the original source to a substitute target; Projection involves attributing one's undesirable feelings to others; Sublimation involves channeling unacceptable impulses into socially acceptable activities. Therefore, in this case, the student's behavior aligns most closely with reaction formation.
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Which client statement should alert a nurse that a client may be responding maladaptively to stress?
- A. I've found that avoiding contact with others helps me cope.
- B. I really enjoy journaling; it's my private time.
- C. I signed up for a yoga class this week.
- D. I made an appointment to meet with a therapist.
Correct Answer: A
Rationale: The correct answer is A. Reliance on social isolation as a coping mechanism is maladaptive and can hinder the development of appropriate coping skills and access to support systems. It may indicate a lack of healthy coping strategies and social connections, which are important for managing stress effectively. Choice B is a positive coping strategy that promotes self-reflection and emotional expression. Choice C reflects a proactive approach to managing stress through physical activity. Choice D shows a willingness to seek professional help, which is a healthy coping mechanism.
Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?
- A. Somatic symptom disorder
- B. Grief responses
- C. Psychosis
- D. Bipolar disorder
Correct Answer: A
Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.
Which statement reflects an accurate understanding of the concepts of mental health and mental illness?
- A. The concepts are rigid and religiously based.
- B. The concepts are multidimensional and culturally defined.
- C. The concepts are universal and unchanging.
- D. The concepts are unidimensional and fixed.
Correct Answer: B
Rationale: Understanding mental health and mental illness as multidimensional and culturally defined is essential for healthcare professionals. Mental health varies across cultures and is influenced by various dimensions such as biological, psychological, social, and spiritual factors. Recognizing these differences helps in providing culturally competent care and understanding the diverse expressions of mental health and illness.
Choice A is incorrect because mental health and mental illness are not rigid or solely based on religion. Choice C is incorrect because mental health and mental illness are not universally experienced in the same way and can change over time. Choice D is incorrect because mental health and mental illness are not unidimensional; they involve various factors and are not fixed in nature.
A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?
- A. Teenagers! They don't know a thing about real stress.
- B. Stress occurs only when there is a loss.
- C. When you are in poor physical condition, you can't experience psychological well-being.
- D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
Correct Answer: D
Rationale: The correct answer is D. Stress can manifest as physical or psychological. A perceived threat to self-esteem can be as stressful as a physiological change. Choice A is dismissive of the teenager's concerns and does not address the issue professionally. Choice B is incorrect as stress can result from various factors, not just loss. Choice C oversimplifies the relationship between physical condition and psychological well-being, neglecting the impact of mental stressors on overall health.
Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?
- A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
- B. It is abnormal for identical twins to react differently to similar stressors.
- C. Identical twins should share the same temperament and respond similarly to stress.
- D. Environmental influences weigh more heavily than genetic influences on reactions to stress.
Correct Answer: A
Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.