A nurse is caring for a client who states, "I am under a great deal of stress at work, but I am able to forget my work and concentrate on my family when I get home at night." The nurse should identify that the client is demonstrating which of the following defense mechanisms?

Choice A reason : Prolonged stress can lead to impaired immune function. When a person is stressed, the body's stress response can suppress the immune system, making it less effective at fighting off infections. This is because stress hormones like cortisol can inhibit the production and function of white blood cells, such as lymphocytes, which are crucial for the immune response. Additionally, chronic stress can lead to inflammation and reduce the body's ability to respond to immunological challenges, increasing the risk of illness and infection.

Choice B reason : Decreased blood pressure is not typically a manifestation of prolonged stress. In fact, stress can lead to increased blood pressure due to the release of stress hormones that cause vasoconstriction and an increase in heart rate. Over time, this can contribute to hypertension and cardiovascular problems.

Choice C reason : Hypoglycemia, or low blood sugar, is not a direct manifestation of prolonged stress. However, stress can affect blood sugar levels. For individuals with diabetes, stress can make it harder to control blood sugar as stress hormones can cause blood sugar levels to rise. In non-diabetic individuals, stress typically does not cause hypoglycemia.

Choice D reason : Anemia, a condition characterized by a lack of healthy red blood cells, is not a direct result of prolonged stress. Anemia can be caused by a variety of factors, including nutritional deficiencies, chronic diseases, or genetic conditions, but it is not commonly linked to stress.

Choice A reason : Repression is a defense mechanism that involves unconsciously blocking unpleasant feelings, desires, or experiences from one's awareness. It is a way for the ego to protect itself from things that the individual cannot cope with at the moment. In the scenario provided, the client does not seem to be unconsciously blocking out the stress but is instead consciously choosing to focus on different aspects of their life at different times.

Choice B reason : Compartmentalization is a defense mechanism where an individual separates different aspects of their life, allowing them to handle conflicting values or emotions by keeping these aspects in separate 'compartments' in their mind. This seems to be what the client is doing by separating work stress from family life, thus being able to concentrate on family when at home despite the stress at work.

Choice C reason : Regression is a defense mechanism that leads an individual to revert to an earlier stage of development when faced with stress. An example would be an adult throwing a tantrum when they don't get their way, which is not what the client is demonstrating in the scenario⁴.

Choice D reason : Projection is a defense mechanism where an individual attributes their own unacceptable thoughts, feelings, or motives to another person. For instance, someone who is angry at their colleague may accuse the colleague of being hostile towards them. The client's statement does not indicate that they are projecting their feelings onto others⁵.