Nokea
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
Correct Answer: A
Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things as all good or all bad, leading to extreme shifts in perception. In this case, the client initially viewed the psychiatrist as the best doctor but now hates him completely due to feeling abandoned. This sudden shift from idealization to devaluation is characteristic of splitting.
Choice B: Projective identification involves attributing one's own unacceptable feelings or traits onto another. This is not evident in the client's description.
Choice C: Isolation of affect refers to separating emotions from their source. The client is expressing strong emotions towards the psychiatrist, not isolating them.
Choice D: Dissociation involves a disruption in consciousness, memory, identity, or perception. The client is not displaying symptoms of dissociation in this scenario.