Jason is a 31-year-old man in recovery for substance use disorder for methamphetamines. He states that he can stay sober for a few months but always relapses due to boredom. He finally was able to stay sober after he got involved in extreme sports (e.g., hang gliding, windsurfing, and parachuting). He told his nurse practitioner, “I had to literally get high in order to stop getting high.” This is an example of:
Sublimation
Suppression
Projection
Transference
The Correct Answer is A
Choice A reason: Sublimation is a mature defense mechanism where socially unacceptable impulses are transformed into socially acceptable actions. Jason’s shift from drug use to extreme sports channels his need for stimulation into a constructive outlet, making this a textbook example of sublimation.
Choice B reason: Suppression involves consciously choosing to delay or avoid dealing with distressing thoughts or feelings. Jason is not avoiding his impulses; he is redirecting them, which is more consistent with sublimation.
Choice C reason: Projection involves attributing one’s own unacceptable thoughts or feelings to someone else. Jason is not externalizing blame or emotions onto others, so this does not apply.
Choice D reason: Transference refers to redirecting feelings about significant others onto the therapist. Jason’s statement is about his own coping strategy, not about the therapeutic relationship.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Contingency management is a behavioral intervention that uses tangible rewards to reinforce positive behaviors, such as abstinence. Providing vouchers for clean drug screens is a classic example of this approach.
Choice B reason: Operant conditioning is the broader framework under which contingency management falls. While technically correct, it is less specific than contingency management in this context.
Choice C reason: Cognitive learning involves acquiring knowledge and understanding through thought, experience, and the senses. It does not involve external rewards for behavior.
Choice D reason: Stimulus discrimination refers to the ability to distinguish between different stimuli and respond appropriately. It is not relevant to the reward-based system described.
Correct Answer is C
Explanation
Choice A reason: While stress and environmental factors may exacerbate acne, they are not the primary pathophysiological mechanism. Acne vulgaris is fundamentally driven by changes in the pilosebaceous unit, not psychological or allergenic triggers alone.
Choice B reason: UVA/UVB exposure may contribute to skin damage and inflammation, but it is not the direct cause of acne. In fact, some UV exposure may temporarily suppress inflammation, though it is not a therapeutic strategy and does not explain the formation of acne lesions.
Choice C reason: Acne vulgaris results from obstruction and inflammation of pilosebaceous units. This process begins with increased sebum production, follicular hyperkeratinization, and colonization by Cutibacterium acnes, leading to comedones and inflammatory lesions such as papules, pustules, and nodules.
Choice D reason: Keratinocyte proliferation and differentiation abnormalities are more characteristic of conditions like psoriasis. While keratinization plays a role in acne, this description does not fully capture the multifactorial pathogenesis involving sebum, bacteria, and inflammation.
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