A nurse is caring for a client who has major depressive disorder.
The client tells the nurse, "I should be dead.
I have been a failure.”. Which of the following responses should the nurse make?

"You are feeling like a failure.”.

"I see many positive things about you.”.

"You're not the only client who feels this way.”.

"How can you feel that way when you have so much to live for?"

Answer and Explanation

The Correct Answer is A

Choice A rationale

Reflecting the client's feeling back to them, such as "You are feeling like a failure," acknowledges their emotional state without judgment or dismissal. This therapeutic communication technique validates the client's feelings and encourages further exploration of their thoughts and emotions.

Choice B rationale

While intended to be positive, stating "I see many positive things about you" can minimize the client's current feelings and may not address the underlying reasons for their negative self-perception. It can also sound dismissive of their distress.

Choice C rationale

Saying "You're not the only client who feels this way" can minimize the client's individual experience and may make them feel that their feelings are not unique or important. It does not directly address their specific statement of wanting to be dead.

Choice D rationale

Asking "How can you feel that way when you have so much to live for?" invalidates the client's current feelings and can make them feel misunderstood or defensive. It does not address the depth of their despair and suicidal ideation.

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Correct Answer is D

Explanation

Choice A rationale

Encouraging a child to focus solely on the future after a sexual assault can minimize the impact of the trauma and discourage processing the difficult emotions associated with the event. A positive support system allows the child to acknowledge and work through their feelings, not avoid them.

Choice B rationale

Suggesting that the child think about what they did to allow the assault to happen places blame on the victim. A positive support system emphasizes that the assault was not the child's fault and focuses on support and healing, not assigning blame.

Choice C rationale

While concern for the child's well-being is understandable, attempting to monitor all of their relationships can be overly controlling and undermine the child's autonomy and trust. A positive support system balances safety with respect for the child's personal boundaries and development.

Choice D rationale

Anticipating that the child will feel some self-blame is a realistic and empathetic understanding of the potential psychological impact of sexual assault. Survivors often internalize blame, even though they are not at fault. Acknowledging this possibility allows the guardian to provide appropriate support and reassurance.

A. Reaction formation. B. Splitting. C. Projection. D. Suppression.

Correct Answer is D

Explanation

Choice A rationale

Reaction formation involves behaving in a way that is the opposite of one's true feelings. The client's statement focuses on delaying health concerns rather than expressing the opposite of their anxiety about their diagnosis.

Choice B rationale

Splitting is a defense mechanism where individuals view themselves or others as all good or all bad. The client's statement does not demonstrate this polarized thinking; instead, it shows a postponement of addressing their health.

Choice C rationale

Projection involves attributing one's own unacceptable thoughts or feelings onto another person. The client is not attributing their feelings about their cancer diagnosis to someone else; they are simply putting off thinking about it.

Choice D rationale

Suppression is a conscious or semiconscious effort to avoid thinking about disturbing thoughts or feelings. The client is consciously stating their intention to not think about their cancer diagnosis until after their son's wedding, indicating a deliberate avoidance of the topic.

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A nurse is caring for a client who has major depressive disorder.The client tells the nurse, "I should be dead.I have been a failure.”. Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an adolescent who was recently sexually assaulted.Which of the following statements by the adolescent's guardian represents the presence of a positive support system?

Correct Answer is D

Explanation

A nurse is caring for a client who has a new diagnosis of cancer.The client states, "I can't think about my health until after my son is married next week.”. The nurse should identify the client's statement as an indication of which of the following maladaptive defense mechanisms?

Correct Answer is D

Explanation

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A nurse is caring for a client who has major depressive disorder.
The client tells the nurse, "I should be dead.
I have been a failure.”. Which of the following responses should the nurse make?