A 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism?

Projection

Repression

Denial

Regression

Answer and Explanation

The Correct Answer is D

A.   Projection involves attributing one’s own unacceptable feelings or thoughts onto another person. However, in this case, the patient’s tantrum and crying are more about their own inability to handle the refusal rather than projecting feelings onto others.
B.   Repression is a defense mechanism where distressing thoughts or feelings are unconsciously blocked from entering awareness. For instance, if the patient were to push aside their feelings of disappointment about not receiving the diet pills without expressing them, that would be repression.
C.   Denial involves refusing to accept reality or facts that are distressing or threatening. However, the primary behavior in this situation is the tantrum and crying, which are more indicative of another defense mechanism rather than outright denial.
D.   Regression is a defense mechanism where an individual reverts to behaviors characteristic of an
earlier developmental stage in response to stress or conflict. The patient’s crying and tantrum can be seen as regressive behavior because it reflects a return to more childlike or immature ways of handling frustration, similar to how a child might react to not getting what they want.

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Correct Answer is B

Explanation

A. Sharing personal information can blur the professional boundaries and hinder the therapeutic relationship. The nurse's focus should be on the client's needs and well-being.
B. Maintaining professional boundaries is essential in therapeutic relationships. It helps to establish trust and ensures the nurse can provide effective care without becoming emotionally involved.
C. Comparing the client to someone else can be misleading and inappropriate. It's important to focus on the client as an individual and avoid making comparisons.
D. While empathy and compassion are crucial in nursing, developing an emotional commitment can compromise objectivity and hinder the nurse's ability to provide effective care.

A. A severely depressed client with history of a brain tumor B. A client with severe, long-lasting depression C. A client with mild depression D. A severely depressed client with congestive heart failure

Correct Answer is B

Explanation

A. A history of a brain tumor does not automatically exclude a person from ECT, but it requires careful consideration and evaluation. It would be essential to conduct a thorough assessment, including imaging studies and consultations with specialists, to ensure that ECT would be safe and appropriate in this context.
B. This option is a strong candidate for ECT. ECT is particularly effective for individuals with severe, treatment-resistant depression, especially when other interventions such as medication and psychotherapy have not been successful. ECT is often considered when depression is severe, persistent, and significantly impairs functioning or poses a risk to life.
C. ECT is generally not indicated for mild depression. The treatment is typically reserved for more severe cases where other forms of treatment have failed or when rapid response is necessary. Mild depression can often be managed effectively with psychotherapy, medication, or a combination of both, without the need for ECT.
D. While ECT can be considered for individuals with severe depression and underlying medical conditions, congestive heart failure (CHF) adds a layer of complexity. However, ECT can still be considered if the potential benefits outweigh the risks, and if the patient is carefully monitored and managed by a multidisciplinary team.

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A 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism?

Nursing Test Bank

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