A nurse is counseling a client for the management of anxiety. The client is consistently late for appointments and ignores household chores. The client states, "I'm just too stressed. I need someone to take care of me." The nurse identifies this behavior as an example of which of the following defense mechanisms?

Repression

Introjection

Dissociation

Regression

Answer and Explanation

The Correct Answer is D

A. Repression: Repression involves unconsciously pushing unwanted thoughts, memories, or feelings out of conscious awareness. It involves burying distressing emotions or memories deep in the unconscious mind to avoid dealing with them consciously. In this scenario, the client's behavior does not suggest the repression of any specific thoughts or memories but rather a coping mechanism related to their current stress and anxiety.

B. Introjection: Introjection occurs when an individual internalizes the values, beliefs, or attitudes of others as if they were their own. It involves incorporating external standards or influences into one's own identity. While introjection may contribute to the client's behavior indirectly by influencing their beliefs about needing external support, the primary defense mechanism at play in this scenario is regression.

C. Dissociation: Dissociation involves a disruption in the integration of consciousness, memory, identity, or perception of the environment. It often manifests as a detachment from reality or a sense of being disconnected from oneself or the surrounding environment. While dissociation may occur in response to severe stress or trauma, it typically involves more extreme symptoms than those described by the client in this scenario.

D. Regression: Regression involves reverting to earlier, less mature behaviors or stages of development in response to stress or anxiety. It reflects a retreat to a more comfortable or familiar state in an attempt to cope with overwhelming emotions or situations. In this scenario, the client's statement about needing someone to take care of them suggests a desire to return to a state of dependency, which is characteristic of regression as a defense mechanism.

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Correct Answer is C

Explanation

A. Restrain the child physically: Physically restraining a toddler during a temper tantrum can escalate the situation and may lead to the child feeling scared or more frustrated. It's important to avoid physical force as it can be traumatic for the child and potentially harmful.

B. Ignore the temper tantrums: Ignoring temper tantrums might work in some situations, but it's not always the most effective strategy. Toddlers often tantrum to seek attention or express frustration, and ignoring them entirely may not address the underlying issue. Additionally, consistent ignoring can lead to feelings of abandonment or exacerbate the behavior.

C. Distract the child by offering to play a game: Distraction can be an effective technique for managing temper tantrums in toddlers. Offering to engage the child in a fun activity or game can redirect their focus away from the source of frustration, helping to de-escalate the situation and promote positive behavior.

D. Tell the child that temper tantrums are not acceptable: While it's important to set boundaries and teach appropriate behavior, telling a toddler that temper tantrums are not acceptable may not effectively address the immediate situation. Toddlers may not fully understand or be able to control their emotions, so simply telling them that tantrums are unacceptable without providing alternative coping strategies is unlikely to be effective.

A. Playing a game of chess with the client B. Giving the client choices of activities C. Encouraging decision-making D. Spending time sitting with the client

Correct Answer is D

Explanation

A. Playing a game of chess with the client: While engaging in activities with the client can be therapeutic, it's essential to consider the client's preferences and level of interest. Some clients with severe depression may not have the motivation or energy to participate in activities like playing chess. Additionally, the focus should be on providing support and empathy rather than suggesting specific activities.

B. Giving the client choices of activities: Offering choices of activities can empower the client and promote autonomy, which is beneficial. However, individuals with severe depression may struggle with decision-making and may feel overwhelmed by choices. Therefore, while offering choices can be therapeutic, it's essential to provide support and guidance in decision-making if needed.

C. Encouraging decision-making: Encouraging decision-making can be beneficial for clients with depression as it promotes a sense of control and self-efficacy. However, individuals with severe depression may find decision-making challenging due to feelings of hopelessness or low energy levels. Therefore, while encouraging decision-making, it's essential to provide support and assistance as needed.

D. Spending time sitting with the client: This is the most therapeutic approach listed. Spending time with the client provides emotional support, companionship, and a nonjudgmental presence, which can be invaluable for someone experiencing severe depression. Simply being present and available to listen without pressure to talk or engage in activities can convey empathy and understanding, fostering a therapeutic nurse-client relationship.

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Naxlex Comprehensive Predictor Exams

A parent of a toddler asks a nurse at a well-child visit how the child's frequent temper tantrums can best be handled. Which of the following actions should the nurse suggest to the parent?

Correct Answer is C

Explanation

A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the client's plan of care?

Correct Answer is D

Explanation

A nurse is caring for a group of older adult clients. Which of the following manifestations indicates one of the clients is experiencing delirium?

A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client?

A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan?

A nurse is caring for a client who has autism spectrum disorder. Which of the following findings should the nurse expect?

A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches, the client states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following responses should the nurse make?

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make?

A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements by the parent indicates an understanding of the teaching?

A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?