A nurse is assessing a client who has a recent diagnosis of dissociative identity disorder. The client tells the nurse, "I think my blackouts are actually caused by low blood sugar." The nurse should recognize the client is using which of the following defense mechanisms?
Suppression
Sublimation
Projection
Rationalization
The Correct Answer is D
Choice A reason: Suppression is a conscious decision to delay paying attention to an emotion or need in order to cope with the present reality. It's unlikely that the client is consciously choosing to ignore the cause of their blackouts.
Choice B reason: Sublimation is a way of dealing with unacceptable impulses by unconsciously substituting acceptable forms of expression. This defense mechanism doesn't typically apply to explaining symptoms like blackouts.
Choice C reason: Projection involves attributing one's own unacceptable thoughts or feelings to another person. Since the client is providing an explanation for their own symptoms, rather than attributing them to someone else, projection is not the defense mechanism at play here.
Choice D reason: Rationalization involves justifying behaviors or feelings with logical reasons, even if they are not appropriate. The client's attribution of blackouts to low blood sugar, despite a diagnosis that suggests a psychological cause, is a form of rationalization.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Asking "Why did you feel like giving away your belongings?" could be perceived as confrontational or judgmental. It's important to approach the client with empathy and without implying that their actions were wrong or require justification.
Choice B reason: "Can you tell me how you have been feeling lately?" is an open-ended question that invites the client to share their feelings and experiences. It demonstrates the nurse's interest in understanding the client's emotional state and provides a safe space for the client to express themselves.
Choice C reason: Saying "Everyone feels a little down sometimes." minimizes the client's experience and the severity of major depressive disorder. It fails to acknowledge the unique and serious nature of the client's condition.
Choice D reason: While suggesting "You should find a support group to attend." can be helpful, it may be more appropriate after establishing a rapport and understanding the client's current state. It's also important to offer support in finding resources rather than directing the client.
Correct Answer is D
Explanation
Choice A reason: While ECT has been used to treat various mental health conditions, its effectiveness in treating borderline personality disorder is not well-established. Borderline personality disorder is typically managed with psychotherapy, and there is limited evidence to support the use of ECT for this condition.
Choice B reason: ECT is not typically used to treat phobias such as a fear of heights. Phobias are usually addressed with cognitive-behavioral therapy and sometimes medication, but not with ECT. Therefore, a decreased fear of heights would not be a typical indicator of ECT's effectiveness.
Choice C reason: ECT may be used in some cases of epilepsy to reduce the frequency of seizures, but it is not a common treatment for this condition. The primary use of ECT is for severe psychiatric conditions, particularly major depressive disorder, and not for neurological disorders like epilepsy.
Choice D reason: ECT is most commonly used to treat severe depression, especially when it is resistant to other treatments. It is known for its rapid and significant improvements in severe symptoms of depression. An improvement in the manifestations of depression, such as a better mood, increased appetite, and improved sleep, is a clear indication that ECT is effective.
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