A nurse is caring for a client who smokes and has lung cancer. The client reports, “I'm coughing because I have that cold that everyone has been getting.”
The nurse should identify that the client is using which of the following defense mechanisms?
Denial
Reaction formation
Sublimation
Suppression
The Correct Answer is A
Denial is a defense mechanism where an individual refuses to accept or acknowledge the existence of a problem or a reality that causes anxiety or distress. In this scenario, the client is denying that their coughing is related to their lung cancer, and instead attributing it to a common cold that everyone is getting. This denial may be a way for the client to avoid facing the reality of their illness and the potential consequences of smoking.
Option b, reaction formation, is a defense mechanism where an individual expresses feelings or behaviors that are the opposite of their true feelings to reduce anxiety.
Option c, sublimation, is a defense mechanism where an individual channels their unacceptable impulses into more acceptable or socially appropriate behaviors.
Option d, suppression, is a defense mechanism where an individual consciously pushes down or avoids their thoughts or feelings. None of these defense mechanisms are being exhibited in the scenario described.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Therapeutic communication involves actively listening to the client, demonstrating empathy, and using open-ended questions to encourage the client to express their thoughts and feelings.
Reflecting (option a) and listening attentively (option b) are both examples of effective therapeutic communication techniques as they demonstrate active listening and empathy.
However, offering advice (option c) is a barrier to therapeutic communication because it implies that the nurse knows what is best for the client and can solve their problems for them.
This can create a power dynamic in the nurse-client relationship and may discourage the client from expressing their true thoughts and feelings. Giving information (option d) can be an important aspect of therapeutic communication, but it should be done in a way that respects the client's autonomy and involves collaboration rather than giving directives.

Correct Answer is B
Explanation
Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise. Binge eating refers to the consumption of an abnormally large amount of food within a short period, accompanied by a feeling of loss of control overeating. After bingeing, individuals with bulimia nervosa feel guilty, ashamed, and anxious about their behavior, and try to compensate by purging.
Options a, c, and d are incorrect as they do not accurately describe the characteristic features of bulimia nervosa.
Avoiding social gatherings and family meals is a characteristic of social anxiety disorder, not bulimia nervosa. Restricting caloric intake all the time is a characteristic of anorexia nervosa, a different type of eating disorder. Following a strict diet and exercise program is not necessarily a characteristic of bulimia nervosa, although some individuals with bulimia nervosa may engage in excessive exercise as a compensatory behavior.

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