A client is admitted with post-traumatic stress disorder following a fire in his home in which family members died. Which of the following should the nurse recognize as an adaptive defense mechanism?

The client makes a decision to postpone a needed surgery.

The client begins reading a book when he experiences hand tremors in response to loud noise.

The client focuses on discussing his daily routine when asked about the fire.

The client develops stomach pains when fire is seen on television.

Answer and Explanation

The Correct Answer is B

Choice A reason: Postponing needed surgery is a maladaptive defense mechanism, likely denial or avoidance, as it delays essential care. In PTSD, trauma-related hyperarousal from amygdala hyperactivity may drive avoidance, but this action risks health deterioration, making it non-adaptive compared to coping strategies that address symptoms directly.

Choice B reason: Reading a book during hand tremors triggered by loud noise is an adaptive defense mechanism, likely distraction or self-soothing. In PTSD, this helps manage hyperarousal from overactive amygdala responses to trauma cues, allowing the client to regain control without avoiding necessary activities, promoting emotional regulation.

Choice C reason: Focusing on daily routines when asked about the fire suggests avoidance, a maladaptive defense in PTSD. This behavior, driven by amygdala-mediated fear responses, prevents processing trauma, potentially worsening symptoms like intrusive thoughts, making it less adaptive than engaging in active coping strategies.

Choice D reason: Developing stomach pains when seeing fire on television indicates somatization, a maladaptive defense in PTSD. This psychosomatic response reflects unprocessed trauma, as the amygdala triggers physical symptoms under stress, hindering emotional recovery and making it less adaptive than coping mechanisms like distraction or grounding.

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Correct Answer is B

Explanation

Choice A reason: Common side effects of disulfiram include mild nausea, headache, or fatigue, resulting from its inhibition of aldehyde dehydrogenase. However, severe nausea and vomiting are not typical unless triggered by alcohol consumption, which causes a disulfiram-alcohol reaction, making this an unlikely primary cause of the client’s distress.

Choice B reason: Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde buildup when alcohol is consumed, leading to severe nausea, vomiting, and flushing. This disulfiram-alcohol reaction is the most likely cause of the client’s symptoms, as it is designed to deter alcohol use in substance abuse treatment, matching the described distress.

Choice C reason: An overdose of disulfiram is rare and typically causes symptoms like drowsiness or confusion, not severe nausea and vomiting. The client’s symptoms align more closely with the disulfiram-alcohol reaction, which is a pharmacological effect, not an overdose, making this an unlikely cause.

Choice D reason: An allergic response to disulfiram might cause rash, itching, or anaphylaxis, but severe nausea and vomiting are not typical allergic symptoms. These symptoms are more consistent with the disulfiram-alcohol reaction, where acetaldehyde accumulation triggers intense gastrointestinal distress, ruling out allergy as the likely cause.

A. Decrease the time available for interaction with people B. Manipulate others C. Prevent aggressive and impulsive behaviors D. Decrease anxiety

Correct Answer is D

Explanation

Choice A reason: Repetitive cleaning in OCD is not primarily to avoid social interaction but to alleviate anxiety from obsessive thoughts. While isolation may occur, it’s secondary, making this incorrect for the behavior’s purpose.

Choice B reason: OCD cleaning is not manipulative; it’s driven by internal distress, not intent to control others. The behavior aims to reduce anxiety, not influence people, making this incorrect for the client’s motivation.

Choice C reason: Cleaning in OCD doesn’t prevent aggression or impulsivity but addresses anxiety from intrusive thoughts. These behaviors are ritualistic, not related to impulse control, making this incorrect for the purpose.

Choice D reason: Repetitive cleaning in OCD is a compulsion to reduce anxiety caused by obsessive thoughts. The behavior temporarily alleviates distress, aligning with OCD’s core mechanism, making this the correct choice.

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A client is admitted with post-traumatic stress disorder following a fire in his home in which family members died. Which of the following should the nurse recognize as an adaptive defense mechanism?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and finds that the client demonstrates constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following?

Correct Answer is D

Explanation

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