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A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, 'I work hard to provide for my family. I don't see why I can't drink to relax.' The nurse recognizes the use of which defense mechanism?
- A. Projection
- B. Rationalization
- C. Regression
- D. Sublimation
Correct Answer: B
Rationale: The nurse should recognize that the client is using rationalization, a common defense mechanism. Rationalization involves creating logical reasons to justify unacceptable feelings or behaviors. In this scenario, the client is justifying excessive drinking by linking it to hard work and the need for relaxation, masking the true underlying issue of alcohol abuse. Projection involves attributing one's thoughts or feelings to others, regression involves reverting to an earlier stage of development, and sublimation involves channeling unacceptable impulses into socially acceptable activities, none of which are demonstrated in the client's statement.
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A healthcare professional is assessing a client diagnosed with anorexia nervosa. Which of the following findings should the healthcare professional expect? Select one that doesn't apply.
- A. Amenorrhea
- B. Lanugo
- C. Hypotension
- D. Hyperkalemia
Correct Answer: D
Rationale: Findings in a client diagnosed with anorexia nervosa include amenorrhea, lanugo, hypotension, and bradycardia. Hyperkalemia is not typically associated with anorexia nervosa. In anorexia nervosa, electrolyte imbalances often lead to hypokalemia, which is low potassium levels, due to malnutrition and potential purging behaviors. Hyperkalemia, high potassium levels, is not a common finding in individuals with anorexia nervosa.
Which of the following are therapeutic communication techniques that a healthcare professional can use when interacting with clients? Select one that doesn't apply.
- A. Using silence
- B. Offering self
- C. Giving advice
- D. Providing reassurance
Correct Answer: C
Rationale: Therapeutic communication techniques aim to promote understanding and trust between the professional and the client. Using silence allows the client to process thoughts, feelings, and information. Offering self involves making oneself available and showing empathy. Providing reassurance helps instill confidence. However, giving advice can sometimes be non-therapeutic as it may undermine the client's autonomy and decision-making process.
When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should one anticipate?
- A. Decreased resistance to disease
- B. Increased libido
- C. Decreased blood pressure
- D. Increased inflammatory response
Correct Answer: A
Rationale: When stress is prolonged, the body reaches the stage of exhaustion in the general adaptation syndrome, where compensatory mechanisms fail, and diseases of adaptation may occur. One physiological effect includes a decreased immune response, leading to decreased resistance to disease. Therefore, the correct answer is A. Increased libido (choice B) is not a typical physiological effect related to prolonged stress. Decreased blood pressure (choice C) is not commonly associated with sustained stress. Increased inflammatory response (choice D) may occur in the short term due to stress, but over a prolonged period, the immune system's function weakens, leading to decreased resistance to disease.
Which symptom should a healthcare provider identify as typical of the fight-or-flight response?
- A. Pupil dilation
- B. Increased heart rate
- C. Decreased salivation
- D. Decreased peristalsis
Correct Answer: B
Rationale: The correct answer is B: Increased heart rate. During the fight-or-flight response, the sympathetic nervous system is activated, causing the release of epinephrine. This hormone triggers an increase in heart rate to supply more blood to the muscles for a rapid response. Pupil dilation occurs to enhance vision in preparation for quick reactions. On the other hand, salivation and peristalsis decrease as the body prioritizes functions necessary for immediate action rather than digestion-related activities. Therefore, choices A, C, and D are incorrect as they do not align with the typical physiological changes associated with the fight-or-flight response.
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.