Chapter 2 - 432
A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The
client states, "I work hard to provide for my family. I don't see why I can't drink to relax." The nurse recognizes the use of
which defense mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation - ANS -ANS: B
The nurse should recognize that the client is using rationalization, a common defense mechanism. The client is attempting
to make excuses and create logical reasons to justify unacceptable feelings or behaviors.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior should be identified by a nurse as
indicative of which defense mechanism?
A. Displacement
B. Projection
C. Reaction formation
D. Sublimation - ANS -ANS: C
The nurse should identify that the boy is using reaction formation as a defense mechanism. Reaction formation is the
attempt to prevent undesirable thoughts from being expressed by expressing opposite thoughts or behaviors.
Displacement refers to transferring feelings from one target to another. Rationalization refers to making excuses to justify
behavior. Projection refers to the attribution of unacceptable feelings or behaviors to another person. Sublimation refers to
channeling unacceptable drives or impulses into more constructive, acceptable activities.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A husband accuses his wife of infidelity. Which situation would indicate to the nurse the husband's use of the ego defense
mechanism of projection?
A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
B. The husband ignores the wife's continued absence from the home.
C. The husband has already admitted to having an affair with a coworker.
D. The husband takes out his marital frustrations through employee abuse. - ANS -ANS: C
Projection is the attribution of feelings or impulses unacceptable to one's self to another person. In this situation, the
husband attributes his infidelity to his wife.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a patient?" Which of
these responses by the nurse would be most accurate?
A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders
(DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing
factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from. - ANS -ANS: A
The DSM-5 is an organized manual describing mental disorders and the criteria that determine whether a given diagnosis
is appropriate. It is published by the American Psychiatric Association (APA). It intends to facilitate accurate and reliable
medical diagnosis and treatment. Item C describes nursing rather than medical diagnosis.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated." Which is a correct
evaluation of this nurse's statement?
A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The
client states, "I work hard to provide for my family. I don't see why I can't drink to relax." The nurse recognizes the use of
which defense mechanism?
A. Projection
B. Rationalization
C. Regression
D. Sublimation - ANS -ANS: B
The nurse should recognize that the client is using rationalization, a common defense mechanism. The client is attempting
to make excuses and create logical reasons to justify unacceptable feelings or behaviors.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A fourth-grade boy teases and makes jokes about a cute girl in his class. This behavior should be identified by a nurse as
indicative of which defense mechanism?
A. Displacement
B. Projection
C. Reaction formation
D. Sublimation - ANS -ANS: C
The nurse should identify that the boy is using reaction formation as a defense mechanism. Reaction formation is the
attempt to prevent undesirable thoughts from being expressed by expressing opposite thoughts or behaviors.
Displacement refers to transferring feelings from one target to another. Rationalization refers to making excuses to justify
behavior. Projection refers to the attribution of unacceptable feelings or behaviors to another person. Sublimation refers to
channeling unacceptable drives or impulses into more constructive, acceptable activities.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A husband accuses his wife of infidelity. Which situation would indicate to the nurse the husband's use of the ego defense
mechanism of projection?
A. The husband cries and stamps his feet, demanding that his wife be true to her marriage vows.
B. The husband ignores the wife's continued absence from the home.
C. The husband has already admitted to having an affair with a coworker.
D. The husband takes out his marital frustrations through employee abuse. - ANS -ANS: C
Projection is the attribution of feelings or impulses unacceptable to one's self to another person. In this situation, the
husband attributes his infidelity to his wife.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A mental health technician asks the nurse, "How do psychiatrists determine which diagnosis to give a patient?" Which of
these responses by the nurse would be most accurate?
A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders
(DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing
factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from. - ANS -ANS: A
The DSM-5 is an organized manual describing mental disorders and the criteria that determine whether a given diagnosis
is appropriate. It is published by the American Psychiatric Association (APA). It intends to facilitate accurate and reliable
medical diagnosis and treatment. Item C describes nursing rather than medical diagnosis.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial
Integrity
\A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated." Which is a correct
evaluation of this nurse's statement?
