During a group therapy session, a nurse notes several clients using multiple defense mechanisms. Which of the following client statements demonstrates the maladaptive use of regression?

"I don't care about work anymore since I was not given a promotion"

"I wrote a short story about a heroic woman when I was really mad at my boss."

" I still cannot remember the scene of my husband's car accident"

"I mentally separate myself from distractions around me when I paint on canvas. "

Answer and Explanation

The Correct Answer is A

A. "I don't care about work anymore since I was not given a promotion":

This statement demonstrates the maladaptive use of regression. Regression involves reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. In this case, the client's response to not receiving a promotion is to display a lack of interest in work, which can be seen as regressing to a less mature coping mechanism.

B. "I wrote a short story about a heroic woman when I was really mad at my boss."

This statement describes the defense mechanism of sublimation rather than regression. Sublimation involves channeling unacceptable impulses or emotions into more socially acceptable activities or behaviors. In this case, the client channels their anger into writing a short story, which is a constructive and creative outlet.

C. "I still cannot remember the scene of my husband's car accident":

This statement does not demonstrate regression. Instead, it suggests repression, which involves the unconscious blocking of unpleasant memories, thoughts, or feelings from conscious awareness. The client's inability to remember the scene of the accident may indicate repression as a defense mechanism.

D. "I mentally separate myself from distractions around me when I paint on canvas."

This statement describes the defense mechanism of dissociation rather than regression. Dissociation involves a disconnection between a person's thoughts, identity, consciousness, or memory. In this case, the client mentally separates themselves from distractions while painting, which is a form of dissociative coping.

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Correct Answer is C

Explanation

A. Before auscultating the chest and abdomen: Examining the tympanic membrane before auscultating the chest and abdomen is not ideal. It's important to follow a systematic approach in physical examination, typically starting with less invasive assessments before progressing to more invasive or uncomfortable ones. Therefore, examining the tympanic membrane before auscultating the chest and abdomen may disrupt this systematic approach.

B. Before examining the head and neck: Similarly, examining the tympanic membrane before examining the head and neck is not appropriate. The head and neck examination typically includes less invasive assessments such as observing the child's appearance, palpating the fontanelles, and inspecting the scalp, face, and neck. The tympanic membrane examination, which involves using an otoscope, is more invasive and should be performed later in the examination.

C. At the end: This is the correct choice. Examining the tympanic membrane at the end of the physical examination allows the nurse to establish rapport with the child and gain their cooperation before performing a potentially uncomfortable or intrusive examination of the ears. Starting with less invasive and more familiar assessments, such as observing the child's general appearance and behavior, auscultating the chest and abdomen, and examining the head and neck, can help build trust and reduce anxiety before proceeding to more specific assessments, such as otoscopy.

D. At the beginning: Examining the tympanic membrane at the beginning of the physical examination may cause the child distress and anxiety, potentially making the rest of the examination more challenging. It's preferable to perform less invasive assessments first to help the child become more comfortable and cooperative before proceeding to more invasive examinations like otoscopy. Therefore, examining the tympanic membrane at the beginning is not recommended.

A. 6 years B. 5 years C. 4 years D. 3 years

Correct Answer is C

Explanation

A. 6 years:

By the age of 6, children typically have developed more advanced motor skills and coordination. Descending stairs by placing both feet on each step and holding onto the railing may be considered overly cautious for a 6-year-old.

B. 5 years:

At the age of 5, children may still be refining their motor skills, but they are usually capable of descending stairs using a more fluid motion, such as placing one foot on each step. Holding onto the railing for support is common but may not be as necessary as in younger children.

C. 4 years:

This is the correct answer. At the age of 4, children often descend stairs by placing both feet on each step and holding onto the railing for support. This method allows for increased stability and safety as they continue to develop balance and coordination.

D. 3 years:

While some children may start to learn how to descend stairs independently by the age of 3, they are more likely to use a one-foot-per-step method or require close supervision. Placing both feet on each step and holding onto the railing for support is less common at this age.

Therefore, option C is the most appropriate age for the described behavior, as it aligns with typical developmental milestones for stair-descending skills in children.

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During a group therapy session, a nurse notes several clients using multiple defense mechanisms. Which of the following client statements demonstrates the maladaptive use of regression?

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