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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: An open wound is a concern for a diabetic client, as it can increase the risk of infection and delay the healing process. However, it does not require an immediate focused assessment, unless it is bleeding profusely, infected, or showing signs of tissue damage.
Choice B reason: Depression is a common complication of diabetes, as it can affect the client's mood, self-care, and adherence to treatment. However, it does not require an immediate focused assessment, unless the client is suicidal, psychotic, or unable to function.
Choice C reason: Chest pain is a symptom that can indicate a life-threatening condition, such as a heart attack, pulmonary embolism, or aortic dissection. It requires an immediate focused assessment, as it can compromise the client's cardiac and respiratory function and lead to death.
Choice D reason: Diabetes is a chronic condition that affects the client's blood glucose levels and can cause various complications, such as neuropathy, nephropathy, and retinopathy. However, it does not require an immediate focused assessment, unless the client is experiencing a hyperglycemic or hypoglycemic crisis.
Correct Answer is B
Explanation
Choice A reason: Hypernatremia is a condition of high sodium levels in the blood. It can cause symptoms such as thirst, dry mouth, confusion, agitation, and seizures. It is not likely to cause postural hypotension, which is a drop in blood pressure when changing positions.
Choice B reason: Hyponatremia is a condition of low sodium levels in the blood. It can cause symptoms such as headache, nausea, vomiting, muscle weakness, fatigue, and confusion. It can also cause postural hypotension, as sodium helps regulate fluid balance and blood pressure.
Choice C reason: Hyperkalemia is a condition of high potassium levels in the blood. It can cause symptoms such as muscle weakness, paralysis, irregular heartbeat, and cardiac arrest. It is not likely to cause postural hypotension, which is more related to fluid and sodium levels.
Choice D reason: Hypokalemia is a condition of low potassium levels in the blood. It can cause symptoms such as muscle cramps, weakness, fatigue, constipation, and arrhythmias. It is not likely to cause postural hypotension, which is more related to fluid and sodium levels.
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