A mental health nurse is caring for a client who smokes and has lung cancer.
The client reports, "I'm coughing because I have that cold everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms?
Reaction formation
Denial
Suppression
Regression.
The Correct Answer is B
While the client's statement might seem like other defense mechanisms, here's why Denial is the most fitting choice: Denial:
Involves refusing to acknowledge a painful or threatening reality.
The client attributes their cough, a potential symptom of lung cancer, to a common cold, dismissing the possibility of their condition worsening.
This allows them to avoid the emotional distress associated with facing their illness. Other options and their rationales:
Reaction formation (Choice A): This involves expressing the opposite of what one truly feels or desires. The client doesn't show any outward signs of expressing emotions opposite to their actual feelings about their health.
Suppression (Choice C): This involves consciously pushing unpleasant thoughts or feelings out of awareness. While the client might downplay the cough, they haven't completely pushed the thought of their illness away.
Regression (Choice D): This involves reverting to an earlier stage of development in response to stress. There's no indication of the client displaying behaviors characteristic of an earlier developmental stage.
Addressing other potential mechanisms:
Displacement: Redirecting emotions towards a less threatening target is not evident in the scenario.
Rationalization: Justifying behavior in a way that avoids facing the true reasons is not seen in the client's explanation. Projection: Attributing one's own feelings or desires to others is not present in the client's statement.
Remember:
Denial is a common coping mechanism for dealing with difficult realities like illness.
It's crucial for the nurse to assess the extent of the client's denial and offer support without judgment.
The goal is to help the client acknowledge their illness while providing emotional support and resources for managing their condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","F"]
Explanation
Choice A: Giving opinion: While sharing your opinions might seem helpful, it can actually shut down communication and make the patient feel judged or invalidated. Therapeutic communication focuses on understanding the patient's perspective, not imposing your own views.
Choice B: Asking why: Asking "why" can often come across as accusatory or judgmental, putting the patient on the defensive and hindering open communication. Instead, use open-ended s or clarifying statements to encourage the patient to elaborate on their feelings and experiences.
Choice C: Silence: In some situations, silence can be a powerful tool. It can provide a safe space for the patient to process their emotions, gather their thoughts, or initiate conversation themselves. However, be sure to use silence actively, paying close attention to nonverbal cues and ensuring the patient feels comfortable with the pause.
Choice D: Change the subject: While there may be times when it's appropriate to redirect the conversation, abruptly changing the subject can leave the patient feeling unheard and dismissed. It's important to acknowledge the patient's concerns and validate their feelings before moving on to another topic.
Choice E: Reflecting: Reflecting involves rephrasing the patient's words or statements in a way that acknowledges and emphasizes their emotions and experiences. This helps the patient feel heard and understood, promoting trust and openness in the communication. For example, if a patient says "I feel so alone," you could reflect by saying "It sounds like you're feeling isolated and disconnected."
Choice F: Clarification: Clarifying statements are a helpful way to ensure you understand the patient correctly. This can involve repeating parts of what they said, summarizing their message, or asking for specific details. For example, if a patient says "I just can't take it anymore," you could clarify by saying "You mentioned you're feeling overwhelmed. Can you tell me more about what's been difficult for you?"
By utilizing techniques like silence, reflecting, and clarification, nurses can create a safe and supportive environment for their patients in the mental health unit, fostering therapeutic communication that promotes healing and recovery.
Correct Answer is C
Explanation
Choice A rationale: Giving the client a PRN sleeping medication is not the best option in this situation. While it might help the client sleep, it does not address the underlying issue causing the client’s anxiety and restlessness. It’s important to remember that medication should not be the first line of treatment unless necessary. Instead, non- pharmacological interventions should be explored first.
Choice B rationale: Encouraging the client to go back to bed might seem like a reasonable action. However, it might not be helpful if the client is feeling restless and anxious. Forcing the client to stay in bed might increase their anxiety and restlessness. It’s important to address the client’s feelings and provide comfort and reassurance.
Choice C rationale: Remaining with the client is the best action to take in this situation. The client is showing signs of anxiety and restlessness, and the presence of the nurse can provide comfort and reassurance. The nurse can use this time to talk to the client, understand their concerns, and provide emotional support. This can help to alleviate the client’s anxiety and might make it easier for them to relax and eventually sleep.
Choice D rationale: Exploring alternatives to pacing the floor with the client might be a good option, but it’s not the best initial action. While it’s important to provide the client with alternatives to help manage their anxiety, the first step should be to provide comfort and reassurance. Once the client is feeling calmer, the nurse can then discuss different strategies to help manage their anxiety.
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