Defense mechanisms

About a month after their toddler is diagnosed as moderately retarded, the parents discuss the toddler's future, reflecting specifically on plans for their child's independent functioning. The nurse recognizes that the parents: 1. Are using denial 2. Accept the child's diagnosis 3. Are using intellectualization 4. Accept their child's limitations

1. Are using denial Use of denial involves failure to acknowledge the reality of the situation.

A male college student, who is smaller than average and unable to participate in sports, becomes the life of the party and a stylish dresser. The nurse identifies this as an example of the defense mechanism of: 1. Introjection 2. Sublimation 3. Compensation 4. Reaction formation

3. Compensation By developing skills in one area, the individual compensates or makes up for a real or imagined deficiency, thereby maintaining a positive self-image.

A client is habitually expressing anxiety through physical symptoms. Which defense mechanism identified by the nurse is being used by this client? 1. Projection 2. Regression 3. Conversion 4. Hypochondriasis

3. Conversion The development of physical symptoms without a physical cause is an anxiety-reducing mechanism known as conversion.

When teaching about child abuse, the nurse includes the fact that the defense mechanism most often used by the physically abusive individual is: 1. Transference 2. Manipulation 3. Displacement 4. Reaction formation

3. Displacement Displacement is a defense mechanism in which one's pent-up feelings toward a threatening person are discharged on less-threatening others.

A male client experiencing delusion of persecution and auditory hallucinations is admitted for psychiatric evaluation. Later the nurse on the unit greets the client by say, "Good evening, how are you?" The client, who has been referring to himself as "Man", answers, "The man is bad." This is an example of: 1. Dissociation 2. Transference 3. Displacement 4. Reaction formation

1. Dissociation Talking in the third person reflects poor ego boundaries and a dissociated from the real self.

Incidence of child molestation often are revealed years later when the victim is an adult. The nurse teaches that this can best be explained by the ego defense mechanism of: 1. Repression 2. Regression 3. Rationalization 4. Reaction formation

1. Repression Repression is a coping mechanism in which unacceptable feelings are kept out of conscious awareness; later, under stress and anxiety, thoughts or feelings surface and come into one's conscious awareness.

One day a male client with the diagnosis of borderline personality disorder describes a situation that happened at work when his immediate supervisor reprimanded him for not completing an assignment. He explains that it was not his fault and states, "people get angry and take it out on me." Which defense mechanism identified by the nurse was the client using in this situation? 1. Denial 2. Projection 3. Displacement 4. Intellectualization

2. Projection Attributing unacceptable feelings or attributes to others is the mechanism known as projection; the data demonstrate use of this defense mechanism.

The nurse knows that sublimation is a defense mechanism that helps the individual: 1. Act out in reverse something already done or thought 2. Return to an early, less mature stage of development 3. Chanel unacceptable impulses into socially approved behavior 4. Exclude from consciousness things that are psychologically disturbing

3. Channel unacceptable impulses into socially approved behavior The individual using sublimation attempts to fulfill desires by selecting a socially acceptable activity rather than one that is socially unacceptable.

A client with diabetes is able to discuss in great detail the metabolic process in diabetes, while eating a piece of chocolate cake with butter frosting. What defense mechanism does the nurse identify when evaluating this behavior? 1. Rejection 2. Dissociation 3. Displacement 4. Intellectualization

4. Intellectualization Intellectualization occurs when a painful emotion is avoided by means of a rational explanation that removes the event from any personal significance.

6. A new psychiatric nurse states, This clients use of defense mechanisms should be eliminated. Which is a correct evaluation of this nurses statement? A. Defense mechanisms can be self-protective responses to stress and need not be eliminated. B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not eliminated. D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

ANS: A The nurse should know that defense mechanisms serve the purpose of reducing anxiety during times of stress. A client with no defense mechanisms may have a lower tolerance for stress, predisposing him or her to anxiety disorders. Defense mechanisms should be confronted when they impede the client from developing healthy coping skills.

13. A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, I know she wants me. This statement reflects which defense mechanism? A. Displacement B. Projection C. Rationalization D. Sublimation

ANS: B The nurse should determine that the clients statement reflects the defense mechanism of projection. Projection refers to the attribution of ones unacceptable feelings or impulses to another person. When the client passes the blame of the undesirable feelings, anxiety is reduced. Displacement refers to transferring feelings from one target to another. Rationalization refers to making excuses to justify behavior. Sublimation refers to channeling unacceptable drives or impulses into more constructive, acceptable activities.

23. A husband accuses his wife of infidelity. Which situation would indicate to the nurse the husbands 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 wifes 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: C Projection is the attribution of feelings or impulses unacceptable to ones self to another person. In this situation, the husband attributes his infidelity to his wife.

12. An employee uses the defense mechanism of displacement when the boss openly disagrees with suggestions. What behavior would be expected from this employee? A. The employee assertively confronts the boss B. The employee leaves the staff meeting to work out in the gym C. The employee criticizes a coworker D. The employee takes the boss out to lunch

ANS: C The client using the defense mechanism of displacement would criticize a coworker after being confronted by the boss. Displacement refers to transferring feelings from one target to a neutral or less-threatening target.

14. 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: 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.

22. Which is the most significant consequence of the excessive use of defense mechanisms? A. The superego will be suppressed. B. Emotions will be experienced intensely. C. Learning and the ability to grow will be enhanced. D. Problem-solving will be limited.

ANS: D Defense mechanisms become maladaptive when they are used by an individual to such a degree that there is interference with the ability to deal with reality, effective interpersonal relations, or occupational performance.

21. Which is an example of the ego defense mechanism of regression? A. A mother blames the teacher for her childs failure in school. B. A teenager becomes hysterical after seeing a friend killed in a car accident. C. A woman wants to marry a man exactly like her beloved father. D. An adult throws a temper tantrum when he does not get his own way.

ANS: D Regression is the retreating to an earlier level of development and the comfort measures associated with that level of functioning.

27. Which should the nurse recognize as an example of the defense mechanism of repression? A. A student aware of the need to study for tomorrows test goes to a movie instead. B. A woman whose son was killed in Iraq does not believe the military report. C. A man who is unhappily married goes to school to become a marriage counselor. D. A woman was raped when she was 12 and no longer remembers the incident.

ANS: D Repression is the involuntary blocking of unpleasant feelings and experiences from ones awareness.

17. When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial? A. Hiding liquor bottles in a closet B. Yelling at their son for slouching in his chair C. Burning dinner on purpose D. Saying to the spouse, I dont drink too much!

ANS: D The nurse should associate the client statement I dont drink too much! with the use of the defense mechanism of denial. The client who refuses to acknowledge the existence of a real situation and the feelings associated with it is using the defense mechanism of denial.