An occupational health nurse is discussing health promotion with a client who has a history of obesity. Which of the following comments indicates the client is using rationalization as a coping mechanism?

The correct answer is Choice D because, "Household contacts will receive prophylactic antibiotics." The nurse should include in the teaching that household contacts of the child with pertussis will receive prophylactic antibiotics to prevent the spread of the disease. This answer is correct because pertussis is a highly contagious respiratory illness that spreads through respiratory droplets, and prophylactic antibiotics can help prevent the spread of the disease.

Choice A is wrong because is incorrect because a dehumidifier will not prevent the spread of pertussis.

Choice B is wrong because is incorrect because pertussis does not cause a rash.

Choice C is wrong because is incorrect because herd immunity occurs when a large percentage of the population is immunized against a disease, and pertussis is preventable with vaccination.

The correct answer is Choice A because, "I am obese because it's in my genes." The client is using rationalization as a coping mechanism by justifying their obesity as being predetermined by their genes, rather than acknowledging their personal responsibility in managing their weight. Rationalization is a defense mechanism in which a person gives a false or socially acceptable explanation for an unacceptable behavior or situation.

Choice B is wrong because, "I have difficulty resisting the items in vending machines," is not the correct answer because it is an excuse rather than a rationalization.

Choice C is wrong because, "I know you don't like me because I am obese," is not the correct answer because it is an example of projection, in which the client attributes their own feelings of dislike to others.

Choice D is wrong because, "I have lots of health problems from being obese," is not the correct answer because it is a justification, not a rationalization