A nurse is caring for an adult client who is receiving treatment for alcohol use disorder. The client is upset because his partner has refused to visit him in the treatment facility. Which of the following actions by the client should indicate to the nurse that the client is using regression as a defense mechanism?

The client states that he has developed sudden hearing loss

The client states that his partner will not visit because they are too busy with their job

The client yells obscenities at the nurse

The client stomps his fees and throws objects of the bedside table

Answer and Explanation

The Correct Answer is D

A. The client states that he has developed sudden hearing loss: This could potentially be an example of somatization, where psychological distress is expressed through physical symptoms. However, sudden hearing loss alone might not specifically indicate regression.

B. The client states that his partner will not visit because they are too busy with their job: This statement does not directly suggest regression. It appears to be an explanation or justification for the partner's behavior.

C. The client yells obscenities at the nurse: Yelling obscenities could indicate frustration or anger, but it does not necessarily suggest regression. It could be a response to the current situation rather than a regressive behavior.

D. The client stomps his feet and throws objects off the bedside table: This behavior could indicate regression. Stomping feet and throwing objects are more characteristic of childish or immature behavior, which suggests a regression to an earlier stage of emotional development.

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Correct Answer is C

Explanation

A. Remain 15 cm (6 in) away from the client: Maintaining a safe physical distance is important to ensure the safety of both the client and the staff member. However, the specific distance may vary depending on the situation and the client's level of agitation. It's essential to maintain a safe distance while still engaging with the client in a supportive manner.

B. Use a raised voice when speaking to the client: Using a raised voice can escalate the situation further and may increase the client's agitation or aggression. It's important to speak calmly and softly to avoid escalating the situation.

C. Determine the cause of the client's feelings: Understanding the underlying reasons for the client's aggression can help the nurse address the root cause and implement appropriate interventions. It's important to listen actively to the client, validate their feelings, and demonstrate empathy.

D. Ask the client short close-ended questions: Close-ended questions typically elicit simple "yes" or "no" responses and may not encourage open communication or help the client express their feelings. Instead, it's more beneficial to ask open-ended questions that allow the client to express themselves and feel heard.

A. Cognitive reframing B. Thought stopping C. Validation therapy D. Operant conditioning

Correct Answer is C

Explanation

A. Cognitive reframing:

Cognitive reframing involves helping individuals change their perspective or interpretation of a situation to see it in a more positive or balanced light. While this technique can be helpful in various situations, it may not be suitable for addressing delusions or misconceptions in clients with dementia who firmly believe in their reality, such as the client who perceives a doll as her infant child.

B. Thought stopping:

Thought stopping is a cognitive-behavioral technique used to interrupt or stop intrusive or distressing thoughts. It typically involves mentally or verbally interrupting negative thoughts with a cue word or phrase. However, this technique may not be effective for addressing the belief of a client with dementia that a doll is her infant child because it does not acknowledge or validate the client's reality.

C. Validation therapy:

Validation therapy is a person-centered approach that acknowledges and validates the emotions and experiences of individuals with dementia, even if their perceptions do not align with objective reality. It involves empathetic listening, validation of emotions, and entering the individual's reality to provide comfort and support. This approach can help reduce agitation and distress in clients with dementia and foster a therapeutic connection between the client and the caregiver.

D. Operant conditioning:

Operant conditioning is a behavior modification technique based on the principles of reinforcement and punishment to strengthen or weaken behaviors. While it may be used to modify behaviors in some situations, it is not typically employed to address delusions or misconceptions in clients with dementia. Using operant conditioning techniques with a client who believes a doll is her infant child would not address the underlying emotional needs or provide therapeutic support for the client's reality.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is using de-escalation techniques with a client who has become verbally aggressive with a staff member. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a client who has dementia and insists a doll is her infant child. Which of the following behavioral management techniques should the nurse use when interacting with the client?

Correct Answer is C

Explanation

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A nurse is creating a plan of care for a client who has panic disorder. Which of the following interventions should the nurse include?

A nurse on a mental health unit is leading a group therapy session for a group of clients. Which of the following statements should the nurse expect from a client who has illness anxiety disorder?

A mental health nurse is providing preventive care for a group of clients in the community. Which of the following actions by the nurse demonstrates a secondary prevention strategy?

A nurse is conducting a child maltreatment screening of a family who has a toddler. Which of the following findings should the nurse identify as an indicator of possible child neglect?

A nurse is caring for a client who has posttraumatic stress disorder (PTSD) after being physically assaulted. The client is unable to recall any details of the event. Which of the following defense mechanisms should the nurse recognize that the client is displaying?

A nurse is creating a plan of care for a newly admitted client who has obsessive-compulsive disorder. Which of the following interventions should the nurse include?

A nurse in a well-child clinic receives a phone call from the parent of an adolescent client. The parent states. "I think my son might try to kill himself." Which of the following statements by the parent is the priority for the nurse to investigate further?