A nurse is assessing a client who has anorexia nervosa and began treatment 1 month ago. Which of the following findings indicates the client's adherence to the treatment plan?

The correct answer is Choice A, displacement.

Rationale for Choice A, displacement:

• Definition of displacement:Displacement is a defense mechanism in which a person redirects their emotions or impulses from the original target to a less threatening one.It's a way of coping with anxiety or frustration by channeling those feelings onto a safer object or person.
• Evidence in the scenario:The client is angry with his partner,but instead of expressing that anger directly to her,he redirects it towards the nurse.This suggests that he finds it safer to express his anger towards the nurse,who is less likely to retaliate or reject him,than towards his partner.

Rationale for other choices:

• Choice B, rationalization:Rationalization involves justifying one's actions or thoughts with excuses or explanations that make them seem more acceptable.There's no evidence in the scenario that the client is trying to justify his anger or provide excuses for it.
• Choice C, denial:Denial involves refusing to acknowledge or accept a painful reality.The client isn't denying his anger; he's openly expressing it.However,he's directing it towards the nurse instead of his partner.
• Choice D, compensation:Compensation involves trying to make up for a perceived weakness or inadequacy by emphasizing a different strength or ability.There's no indication in the scenario that the client is trying to compensate for anything.

Further considerations:

• It's important to note that defense mechanisms are often unconscious,meaning the person using them isn't aware of what they're doing.This can make them difficult to identify and address.
• In this case,the nurse could try to help the client become more aware of his anger and how he's expressing it.They could also encourage him to explore healthier ways of coping with his feelings,such as talking to his partner directly or seeking professional help.

A. Manage conflict within the group.Conflict management is an important skill for a group facilitator, but it is generally more applicable during the working phase of the group when members begin to express differing opinions and emotions.

B. Encourage the use of problem-solving skills.While encouraging problem-solving is beneficial for group members, this intervention is more appropriate for later phases of the group process, once rapport is established and members are actively discussing their issues.

C. Maintain the group's focus on identified issues.Keeping the group focused on specific issues is important for effective group work. However, in the orientation phase, the primary goal is to introduce the group, establish guidelines, and build relationships.

D. Establish a rapport with group members.In the orientation phase of a support group, the nurse's primary objective is to establish trust and build rapport. Creating a supportive and welcoming environment is essential for adolescents, as it sets the stage for open communication.