A nurse is caring for a client following a suicide attempt.
The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions is the nurse's priority?

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.

Choice A rationale:

Obsession over a fictitious defect in physical appearance is characteristic of body dysmorphic disorder, not generalized anxiety disorder (GAD).

Individuals with body dysmorphic disorder become preoccupied with an imagined or slight defect in their appearance, often to the point of significant distress and impairment in functioning.

They may engage in excessive grooming behaviors, repeatedly check their appearance in mirrors, or avoid social situations due to their appearance concerns.

While individuals with GAD may also experience concerns about their physical appearance, these concerns are typically not as severe or pervasive as those seen in body dysmorphic disorder.

Choice B rationale:

Constant worry about the undiagnosed presence of an illness is a hallmark feature of GAD.

Individuals with GAD often experience excessive worry about a variety of things, including health, finances, relationships, and work.

This worry is often accompanied by physical symptoms such as restlessness, fatigue, difficulty concentrating, and muscle tension.

The worry is typically difficult to control and can significantly interfere with daily life.

Choice C rationale:

Sudden unexplained loss of vision without a physical medical explanation is not a common symptom of GAD. It may be indicative of a more serious medical condition, such as a stroke or a neurological disorder.

It is important to rule out any potential medical causes before attributing a symptom like this to GAD.

Choice D rationale:

Prior physical health followed by the need for two surgeries within the last three months may be a stressful life event that could contribute to the development of GAD.

However, it is not a specific symptom of GAD.

Many people experience stressful life events without developing GAD.

The presence of other symptoms, such as excessive worry and physical symptoms, is necessary for a diagnosis of GAD.