A nurse in a community health facility is interviewing a client who recently lost his job. The client states. "I was fired because my boss doesn't like me." Which of the following defense mechanisms is the client displaying?

Displacement

Rationalization

Dissociation

Repression

Answer and Explanation

The Correct Answer is B

A. Displacement:
Displacement is a defense mechanism where a person redirects their feelings, often negative or hostile ones, from the original source or target to a different, less threatening target. For example, if the client were to express anger at their boss by yelling at their family members instead, it would be an example of displacement.
B. Rationalization:

Rationalization is a defense mechanism in which a person provides logical or reasonable explanations to justify or explain a situation or behavior, even if these explanations are not entirely true or valid. It involves creating justifications or excuses to make an event or one's actions appear more reasonable or acceptable. In this case, the client is rationalizing the job loss by attributing it to their boss not liking them, which may be an oversimplified or inaccurate explanation.
C. Dissociation:

Dissociation is a defense mechanism where a person mentally separates themselves from their own thoughts, feelings, or experiences to cope with overwhelming or traumatic situations. It involves a disconnection from reality. The client's statement doesn't suggest dissociation; rather, they are providing a reason for their job loss.

D. Repression:
Repression is a defense mechanism that involves the unconscious exclusion of painful or anxiety-provoking thoughts, feelings, or memories from awareness. It is not readily visible or expressed in behavior. The client's statement involves a conscious attempt to explain their job loss, so it's not an example of repression.

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Correct Answer is A

Explanation

A. Encourage participants to express conflicts and work toward resolution:
Explanation: During the working phase of therapy, the nurse encourages participants to express their conflicts, fears, and concerns openly. The working phase is characterized by active participation and problem-solving. Encouraging clients to express their feelings and conflicts helps them work through their issues and promotes resolution. It's a crucial step in the therapeutic process, allowing clients to explore their emotions and gain insight into their anxieties.

B. Inform participants about principles for listening to and respecting each other:
Explanation: Setting ground rules for respectful communication is typically done in the initial or pre-working phase of therapy. While maintaining a respectful environment is important throughout the therapeutic process, it's not specific to the working phase.

C. Suggest that participants reflect on their progress as individuals and as a group:
Explanation: Reflection and assessment of progress can occur throughout therapy, not just in the working phase. It's essential for clients to evaluate their progress, but this action is not exclusive to the working phase.

D. Ask participants to become acquainted with and talk to each other:
Explanation: Building rapport and getting acquainted with other group members often occurs in the initial phase of therapy. During the working phase, the focus shifts more toward discussing and resolving specific issues and conflicts rather than introductory activities.

A. Implement measures to prevent intentional self-inflicted injury. B. Discuss the appropriate use of assertive behavior with the client. C. Encourage the client to attend weekly support group meetings. D. Assist the client to maintain awareness of her thoughts and feelings.

Correct Answer is A

Explanation

A. Implement measures to prevent intentional self-inflicted injury:
This choice is the priority. Individuals with borderline personality disorder are at an increased risk of self-harm and suicidal behaviors. Implementing measures to prevent intentional self-inflicted injury, such as close monitoring, removing potentially harmful objects, and creating a safe environment, is crucial to ensuring the client's safety and well-being.

B. Discuss the appropriate use of assertive behavior with the client:
Teaching assertive behavior is an important aspect of therapy for individuals with borderline personality disorder. Learning to express emotions and needs in a healthy, assertive manner can improve their interpersonal skills and relationships. However, this choice is secondary to ensuring the client's safety. Safety concerns need to be addressed before moving on to other therapeutic interventions.

C. Encourage the client to attend weekly support group meetings:
Support group meetings can provide valuable social support and a sense of belonging for individuals with borderline personality disorder. Being part of a supportive community can offer understanding and coping strategies. While this is a beneficial intervention, it is not the priority. Safety concerns and addressing self-harm risk take precedence.

D. Assist the client to maintain awareness of her thoughts and feelings:
Developing self-awareness and emotional regulation skills is essential in managing borderline personality disorder. Techniques such as mindfulness and dialectical behavior therapy (DBT) can help individuals become more aware of their thoughts and emotions. While important for long-term management, this intervention is not the priority when immediate safety concerns are present. Safety should always be the first focus of care.

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A nurse in a community health facility is interviewing a client who recently lost his job. The client states. "I was fired because my boss doesn't like me." Which of the following defense mechanisms is the client displaying?

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