The psychiatric-mental health nurse practitioner discusses with a colleague her feelings about a new client. "I am having unsettling feelings of anger toward this client, whom I just met. I think she reminds me of my mother." This is an example of which defense mechanism?
Projection
Transference
Countertransference
Reaction formation
The Correct Answer is C
Choice A reason: Projection involves attributing one’s own unacceptable thoughts or emotions to another person. In this case, the nurse is not attributing her feelings to the client but recognizing them as her own.
Choice B reason: Transference refers to the client projecting feelings onto the therapist, often based on past relationships. This scenario describes the therapist’s reaction, not the client’s.
Choice C reason: Countertransference occurs when the therapist projects unresolved feelings onto the client, often based on personal history. The nurse’s recognition that the client reminds her of her mother and evokes anger is a textbook example of countertransference.
Choice D reason: Reaction formation involves expressing the opposite of one’s true feelings. The nurse is not masking her anger but acknowledging it, making this choice incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is B
Explanation
Choice A reason: Bupropion is a norepinephrine-dopamine reuptake inhibitor and does not significantly increase serotonin levels. While it can cause seizures in overdose, it is not typically associated with serotonin syndrome.
Choice B reason: Phenelzine is a monoamine oxidase inhibitor (MAOI) that prevents the breakdown of serotonin. When combined with venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), it can lead to dangerously elevated serotonin levels and trigger serotonin syndrome. The symptoms described—tachycardia, diaphoresis, and myoclonic jerks—are classic signs.
Choice C reason: Lorazepam is a benzodiazepine and acts on GABA receptors. It does not affect serotonin levels and is not implicated in serotonin syndrome.
Choice D reason: Hydroxyzine is an antihistamine with anxiolytic properties. It does not influence serotonin metabolism and is not associated with serotonin syndrome.
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