A nurse is providing care for a client who seems anxious following a recent tragedy. Which of the following statements by the client reflects an adaptive use of sublimation?
I will work out in the gym every time I get mad about what happened.
I can’t remember anything that happened, but I am okay.
I do not have anxiety, and I’m not sure why you think I do.
I’m not capable of moving past this time in my life.
The Correct Answer is A
Choice A reason: Sublimation is a defense mechanism where negative emotions, like anger, are channeled into positive or socially acceptable activities, such as exercise. Working out in the gym when feeling mad transforms the emotion into a constructive outlet, reflecting adaptive use of sublimation.
Choice B reason: Forgetting the event suggests repression or dissociation, not sublimation. This response does not involve channeling emotions into productive activities and is not adaptive for addressing anxiety.
Choice C reason: Denying anxiety indicates denial, not sublimation. This statement avoids acknowledging the emotion rather than redirecting it into a positive action, making it non-adaptive.
Choice D reason: Expressing inability to move past the tragedy reflects rumination or despair, not sublimation. It does not involve transforming negative emotions into constructive behaviors, so it is not an adaptive response.
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Correct Answer is D
Explanation
Choice A reason: Directly rejecting the belief is non-therapeutic and may increase defensiveness, damaging trust.
Choice B reason: Telling the client to stop worrying invalidates their feelings and dismisses the emotional impact of the delusion.
Choice C reason: Participating in the delusion by “looking for cameras” reinforces the false belief, which is not supportive of reality testing.
Choice D reason: Acknowledging the client’s fear while gently presenting reality and shifting toward problem-solving helps maintain trust and supports reality testing.
Correct Answer is B
Explanation
Choice A reason:Recalling past coping mechanisms can be helpful, but it is not the priority in acute anxiety. The client may be too overwhelmed to focus on strategies without first establishing a sense of safety.
Choice B reason:Remaining with the client is the priority, as it provides a calming presence, ensures safety, and helps reduce the client’s anxiety by offering immediate support and reassurance during an acute episode.
Choice C reason:Encouraging verbalization of feelings is therapeutic but not the priority in acute anxiety. The client may need time to calm down before they can effectively express their emotions.
Choice D reason:Providing a diverting activity may help manage mild anxiety but is not the priority in an acute, moderate episode. Staying with the client to ensure safety and reduce distress takes precedence.
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