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Which of the following statements should a healthcare professional recognize as true about defense mechanisms? Select the one that doesn't apply.
- A. They are employed when there is a threat to biological or psychological integrity.
- B. They are controlled by the id and deal with primal urges.
- C. They are used in an effort to relieve mild to moderate anxiety.
- D. They are protective devices for the superego.
Correct Answer: B
Rationale: Defense mechanisms are employed by the ego in the face of threats to biological and psychological integrity to relieve mild to moderate anxiety. They act as protective devices for the ego, not the id or superego. The id represents primal instincts, while the superego is associated with moral standards. Defense mechanisms help individuals cope with stressors by redirecting focus and are often unconscious and self-deceptive.
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According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?
- A. A client rudely complaining about limited visiting hours
- B. A client exhibiting aggressive behavior toward another client
- C. A client stating that no one cares
- D. A client verbalizing feelings of failure
Correct Answer: B
Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.
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.
In the treatment of a patient with bipolar disorder experiencing a depressive episode, which medication is commonly prescribed?
- A. Valproic acid
- B. Risperidone
- C. Fluoxetine
- D. Lithium
Correct Answer: C
Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a commonly prescribed antidepressant, is used to manage depressive episodes in bipolar disorder. It helps alleviate symptoms of depression by increasing the levels of serotonin in the brain, which can improve mood and reduce feelings of sadness and hopelessness. While mood stabilizers like lithium are often used in bipolar disorder, for depressive episodes, antidepressants like fluoxetine are preferred to address the specific symptoms associated with depression. Valproic acid is a mood stabilizer often used in bipolar disorder to manage manic episodes. Risperidone is an atypical antipsychotic that may be used in bipolar disorder to help control manic episodes or as an adjunctive treatment, but it is not a first-line medication for depressive episodes.
Which should the individual recognize as an example of the defense mechanism of repression?
- A. A student aware of the need to study for tomorrow's test goes to a movie instead.
- B. A woman whose son was killed in Iraq does not believe the military report.
- C. A man who is unhappily married goes to school to become a marriage counselor.
- D. A woman was raped when she was 12 and no longer remembers the incident.
Correct Answer: D
Rationale: Repression is a defense mechanism where distressing thoughts, feelings, or memories are pushed out of conscious awareness to protect the individual from emotional pain. In this scenario, the woman's inability to recall the traumatic event of being raped at the age of 12 indicates repression in action. Choices A, B, and C do not represent repression. Choice A reflects procrastination, choice B suggests denial, and choice C indicates sublimation as the man is channeling his unhappiness into a constructive pursuit.
A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, 'I know she wants me.' This statement reflects which defense mechanism?
- A. Displacement
- B. Projection
- C. Rationalization
- D. Sublimation
Correct Answer: B
Rationale: The correct answer is B: Projection. The nurse should determine that the client's statement reflects the defense mechanism of projection. Projection refers to the attribution of one's unacceptable feelings or impulses to another person. In this case, the boy is projecting his own desires onto the female teacher, believing that she wants him. By externalizing his feelings, the boy reduces his anxiety and discomfort about his own attraction. Displacement involves transferring emotions from one target to another, not attributing one's own feelings to others. Rationalization involves creating logical explanations for unacceptable behaviors, not projecting feelings onto others. Sublimation is the channeling of unacceptable impulses into socially acceptable actions, which is not demonstrated in this scenario.