NUR 222-Advanced Nursing Study Guide 2020

1. A nurse in an alcohol treatment facility is caring for a client who states, “My job is so stressful that the only way I can cope is to drink.” The nurse should recognize that the client is displaying which of the following defense mechanisms? A. Introjection (Unconscious adoption of the ideas or attitudes of others) B. Repression C. Rationalization D. Intellectualization Repression ● Unconsciously putting unacceptable ideas, thoughts, and emotions out of awareness ● ADAPTIVE USE: A person preparing to give a speech unconsciously forgets about the time when he was young and kids laughed at him while on stage. ● MALADAPTIVE USE: A person who has a fear of the dentist Rationalization ● Creating reasonable and acceptable explanations for unacceptable behavior ● ADAPTIVE USE: An adolescent boy says, “she must already have a boyfriend” when rejected by a girl ● MALADAPTIVE USE: A young adult explains he had to drive home from a party after drinking alcohol because he had to feed his dog Intellectualization ● Separation of emotions and logical facts when analyzing or coping with a situation or event ● ADAPTIVE USE: A law enforcement officer blocks out the emotional aspect of a crime so he can objectively focus on the investigation. ● MALADAPTIVE USE: A person who learns he has a terminal illness focuses on creating a will and financial matters rather than acknowledging his grief. 2. A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client’s history should the nurse report to the provider? A. Knee arthroplasty 1 month ago B. Hepatitis B infection C. Recent head injury (Avoid administering to clients at risk for seizures, such as a client who has a head injury) D. Hypothyroidism Bupropion = ATYPICAL ANTIDEPRESSANT, inhibits Dopamine uptake ○ Alternative to SSRIs for clients unable to tolerate sexual dysfunction side effects ○ Complications: Headache, dry mouth, GI distress, constipation, increased heart rate, nausea, restlessness, insomnia ሁ Suppression of appetite = weight loss, contraindicated for those who have anorexia or bulimia