A nurse is assessing a client who has multiple injuries from a motor vehicle crash as a result of driving while under the influence of alcohol. The client tells the nurse," I had a few drinks after my boss fired me, but it's okay. Everything will work out somehow next week." Which of the following defense mechanisms is the client demonstrating?

Answer: (D) Suppression

Rationale:

A) Dissociation: Dissociation involves a disconnection from reality or the separation of thoughts, memories, or identity from conscious awareness. In this scenario, the client is not displaying any signs of disconnecting from reality or avoiding awareness of the situation through dissociation, making this defense mechanism unlikely.

B) Projection: Projection occurs when an individual attributes their own unacceptable thoughts or feelings to others. The client in this situation is not blaming others or attributing their actions to someone else, so projection is not the defense mechanism being demonstrated here.

C) Intellectualization: Intellectualization involves using reasoning or logic to avoid emotional stress or anxiety. While the client does mention logical-sounding plans about things working out next week, their overall response does not primarily reflect an avoidance of emotion through reasoning, so intellectualization is not the correct choice.

D) Suppression: Suppression is the conscious decision to delay paying attention to an emotion or need in order to cope with the present situation. The client acknowledges the stress of being fired but chooses to push aside their distress by stating that "everything will work out somehow next week," indicating they are consciously choosing to set aside their anxiety for the time being. This aligns with the concept of suppression.

Autonomy is the ethical principle that upholds an individual's right to make decisions about their own care and treatment. Respecting autonomy means acknowledging and honoring a person's right to make choices based on their own values, beliefs, and preferences. By importing a client's wishes to refuse prescribed treatments, the nurse is recognizing and respecting the client's autonomy. This shows that the nurse values the client's right to make decisions about their own healthcare and supports their choice, even if it may differ from what the nurse may recommend.

Incorrect:

A. Spending extra time to calm an agitated client demonstrates the ethical principle of beneficence, which is the duty to promote the well-being and welfare of the client.

B. Ensuring that a client understands expectations for group participation relates to the ethical principle of fidelity, which involves maintaining trust and keeping promises to the client.

C. Describing the adverse effects of a client's medications is important for informed consent and promoting understanding, but it does not directly involve the client's autonomy unless it is accompanied by a discussion of the client's choices and preferences regarding medication.