When the patient who overeats insists that weight gain is related to retained fluids, the nurse recognizes the patient is using which defense mechanism?

A. Preferring to eat meals while watching TV is a common behavior that is not specifically associated with suicidal ideation. It may simply reflect the adolescent's comfort or routine preferences rather than a sign of continued suicidal intent.
B. Giving away personal belongings, such as a CD collection, can be a sign that the adolescent is making arrangements for their belongings in case of death. This behavior can sometimes suggest that the individual may be planning for their end, which could indicate lingering suicidal thoughts. It's important to explore this behavior further with the adolescent to understand their intentions and state of mind.
C. While avoidance of discussing the suicide attempt may indicate emotional distress or a reluctance to engage, it does not directly point to ongoing suicidal intent. It could also reflect a desire for privacy or difficulty in expressing feelings, rather than a clear indication of suicidal ideation.
D. Adolescents often express a desire to spend more time with peers rather than family, which is a common developmental behavior. This preference alone does not necessarily indicate suicidal intent and is more reflective of typical adolescent social behavior.

A. Compensation involves offsetting perceived deficiencies by excelling in other areas. The patient claiming weight gain is due to fluid retention is not trying to make up for a perceived weakness or deficiency; instead, they are explaining their behavior in a way that deflects responsibility.
B. Rationalization is a defense mechanism where a person provides logical or reasonable-sounding explanations for behaviors or situations that are actually motivated by irrational or emotional factors. In this case, the patient who overeats is rationalizing their weight gain by attributing it to fluid retention rather than addressing the underlying issue of overeating. This allows them to avoid facing the real cause of their weight gain.
C. Regression involves reverting to earlier stages of development or behavior when faced with stress. For instance, an adult might act childishly when under pressure. The patient in this scenario is not behaving in a more immature or childlike manner but is rather giving an excuse for their behavior.
D. Projection involves attributing one's own undesirable thoughts or feelings to others. For example, someone who is untrustworthy might accuse others of being untrustworthy. The patient in this scenario is not attributing their own issues to others but is offering an excuse for their own behavior.