A nurse is caring for a client who states, "I did not take my medication because my partner forgot to remind me." The nurse should identify that the client is demonstrating which of the following defense mechanisms?
Identification
Denial
Displacement
Rationalization
The Correct Answer is D
Choice A reason: Identification is a defense mechanism where the person adopts the characteristics or behaviors of someone else, usually someone more powerful or successful, to cope with feelings of inadequacy or insecurity.
Choice B reason: Denial is a defense mechanism where the person refuses to accept or acknowledge the reality of a situation or a problem, to avoid dealing with the negative emotions or consequences.
Choice C reason: Displacement is a defense mechanism where the person transfers their feelings or impulses from the original source to a less threatening or more acceptable one, to reduce the anxiety or guilt.
Choice D reason: Rationalization is a defense mechanism where the person uses logical or plausible explanations to justify or excuse their actions or behaviors, to avoid facing the true motives or reasons.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Fluid volume deficit is a condition in which the body loses more fluid than it gains, resulting in dehydration, hypotension, and electrolyte imbalances. It is not a complication of IV fluid therapy, but rather a reason for initiating it.
Choice B reason: Fluid volume excess is a condition in which the body retains more fluid than it needs, resulting in edema, hypertension, and heart failure. It is a potential complication of IV fluid therapy, especially in older adults who have reduced renal function and cardiac output. The nurse's assessment findings of crackles, shortness of breath, and jugular vein distention are indicative of fluid overload and pulmonary congestion.
Choice C reason: Speed shock is a systemic reaction that occurs when a substance is administered too rapidly into the bloodstream, causing adverse effects such as chest pain, dyspnea, hypotension, and cardiac arrest. It is not a complication of IV fluid therapy, but rather a risk associated with IV medication administration.
Choice D reason: Pulmonary embolism is a blockage of one or more pulmonary arteries by a blood clot, fat, or air, causing impaired gas exchange, chest pain, dyspnea, and hemoptysis. It is not a complication of IV fluid therapy, but rather a possible outcome of venous thromboembolism, which can be prevented by using anticoagulants and mechanical devices.
Correct Answer is A
Explanation
Choice A reason: This is the correct answer because the RN as a teacher aims to promote health literacy, self-management, and shared decision-making among patients and their families. By helping people to become empowered to take care of their health, the RN can facilitate positive health outcomes and prevent complications.
Choice B reason: This is not the correct answer because the RN as a teacher does not focus on explaining what nurses do, but rather on educating patients about their health conditions, treatments, and self-care. While it is important for the patient to understand the role of the nurse, this is not the main goal of teaching.
Choice C reason: This is not the correct answer because the RN as a teacher does not limit teaching to discharge instructions. Teaching is an ongoing process that starts from admission and continues throughout the continuum of care. Discharge instructions are only one component of teaching that summarizes the key information and actions that the patient needs to follow after leaving the hospital.
Choice D reason: This is not the correct answer because the RN as a teacher does not aim to teach patients how to give themselves treatments to get them out of the hospital quicker, but rather to help them achieve optimal health and wellness. Teaching patients how to give themselves treatments is part of the skill development aspect of teaching, but it is not the main goal. The main goal is to help patients understand the rationale, benefits, and risks of their treatments, and to support them in adhering to their treatment plans.
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