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When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
- A. Hiding liquor bottles in a closet
- B. Yelling at their son for slouching in his chair
- C. Burning dinner on purpose
- D. Saying to the spouse, I dont drink too much!
Correct Answer: D
Rationale: The correct answer is D because the client is using denial as a defense mechanism to cope with the stress of being confronted about her alcohol abuse. By saying "I don't drink too much," she is refusing to acknowledge the reality of her excessive alcohol consumption. This denial allows her to avoid facing the uncomfortable truth and the need for change.
A: Hiding liquor bottles in a closet is an example of a defense mechanism called displacement, not denial.
B: Yelling at their son for slouching in his chair is an example of a defense mechanism called projection, not denial.
C: Burning dinner on purpose is an example of a defense mechanism called passive-aggression, not denial.
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An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee?
- A. The employee assertively confronts the boss
- B. The employee leaves the staff meeting to work out in the gym
- C. The employee criticizes a coworker
- D. The employee takes the boss out to lunch
Correct Answer: C
Rationale: Displacement is a defense mechanism where emotions are redirected from the original source to a substitute target. In this case, the employee is likely to displace their anger from the boss onto a coworker by criticizing them. This behavior allows the employee to express their feelings indirectly.
A: Assertively confronting the boss does not align with displacement as it involves direct confrontation.
B: Leaving the meeting to work out in the gym is a form of avoidance and does not involve displacing emotions onto another target.
D: Taking the boss out to lunch is more of a conciliatory gesture and does not involve displacing negative emotions onto someone else.
A nurse directs the client interaction and plans for interventions to achieve client goals. According to Peplaus framework for psychodynamic nursing, what therapeutic role is this nurse assuming?
- A. The role of technical expert
- B. The role of resource person
- C. The role of teacher
- D. The role of leader
Correct Answer: D
Rationale: The correct answer is D: The role of leader. In Peplau's framework, the nurse in this scenario is assuming the therapeutic role of a leader because they are directing client interactions and planning interventions to achieve client goals. This role involves guiding and facilitating the therapeutic process, fostering a collaborative relationship with the client, and empowering them to make decisions and progress towards their goals.
A: The role of technical expert is incorrect because it focuses more on providing specialized knowledge and skills rather than leading and directing client interactions.
B: The role of resource person is incorrect as it typically involves providing information and support, but not necessarily directing client interactions and planning interventions.
C: The role of teacher is incorrect because while education and guidance are important in nursing, it does not fully capture the leadership and direction involved in the scenario described.
What is the priority nursing action during the orientation (introductory) phase of the nurseclient relationship?
- A. Acknowledge the clients actions and generate alternative behaviors.
- B. Establish rapport and develop treatment goals.
- C. Attempt to find alternative placement.
- D. Explore how thoughts and feelings about this client may adversely impact care.
Correct Answer: B
Rationale: The correct answer is B: Establish rapport and develop treatment goals. During the introductory phase of the nurse-client relationship, establishing rapport is essential to build trust and a therapeutic alliance. Developing treatment goals collaboratively with the client sets the foundation for the care plan. This action promotes client engagement and empowerment. Acknowledging client actions and generating alternative behaviors (A) is more suited for later phases. Attempting to find alternative placement (C) is not appropriate in the introductory phase. Exploring how thoughts and feelings impact care (D) is important but not the priority during the orientation phase.
Which should the nurse recognize as an example of the defense mechanism of repression?
- A. A woman whose son was killed in Iraq does not believe the military report.
- B. A man who is unhappily married goes to school to become a marriage counselor.
- C. A woman was raped when she was 12 and no longer remembers the incident.
Correct Answer: C
Rationale: The correct answer is C because repression is a defense mechanism in which traumatic memories are unconsciously blocked from awareness. In this scenario, the woman's inability to remember the rape incident at age 12 is a classic example of repression. She has pushed the memory out of consciousness to avoid the emotional distress associated with it.
Choice A is incorrect as it describes denial, where the woman refuses to accept the truth. Choice B is incorrect as it reflects sublimation, where the man channels his unhappiness into a positive pursuit. Choice D is incomplete, making it impossible to evaluate.
A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, Should I seek psychiatric help for my mother? Which is an appropriate nursing reply?
- A. My mother also worries unnecessarily. I think it is part of the aging process.
- B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.
- C. From what you have told me, you should get her to a psychiatrist as soon as possible.
- D. Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.
Correct Answer: B
Rationale: The correct answer is B because it provides a clear and accurate explanation of when anxiety is considered abnormal. It states that anxiety is abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning. This response shows understanding of the situation and suggests seeking professional help based on specific criteria.
Choice A is incorrect as it dismisses the concerns as part of the aging process without addressing the possibility of abnormal anxiety. Choice C is incorrect as it jumps to the conclusion of seeking psychiatric help without evaluating the level of anxiety or impairment. Choice D is incorrect as it oversimplifies anxiety treatment by suggesting it can only be treated with medications, ignoring the importance of therapy and other interventions.