The mother of a 3-year-old child tells the nurse that
her child hit her doll after the mother scolded her for
picking the neighbors’ flowers. Which defense
mechanism used by the child does the nurse identify
in the mother’s report?
Projection
Sublimation
Coorrre Displacement
ct!
Identification
Rationale: The defense mechanism of
displacement involves the discharge of intense
feelings for one person onto a substitute person
or object that is less threatening to satisfy an
impulse. Projection involves attributing an
attitude, behavior, or impulse, such as that which
occurs in blaming or scapegoating, to someone
else. Sublimation is the act of rechanneling an
impulse into a more socially acceptable object.
Identification involves modeling behavior after
someone else's.
Test-Taking Strategy: Use the process of
elimination and knowledge regarding the subject,
defense mechanisms. Focusing on the data in the
question and the child’s behavior will direct you to
the correct option. Review these defense
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A client says to the nurse, “I’ve been following my diet
and taking my medication. What else do you want to
talk about today?” Which response would be most
helpful during the working phase of the therapeutic
alliance?
“Sounds fine to me. Let’s meet again in 6 months.”
“I don’t believe that you have been following
your diet because you haven’t lost any weight.”
“Well, you’ve talked about diet in your
terms, but perhaps I should test you on
specific things.”
Coorrre
ct! “Some people have added exercise to diet and
medication therapy and gotten positive results.
Do you think that this would work for you?”
Rationale: Although suggestion or overt giving of
advice is sometimes nontherapeutic, these
strategies are therapeutic when used in the
working phase, because in this situation they will
increase the client’s perception of all available
options in the treatment plan. Answering “Sounds
fine to me. Let’s meet again in 6 months” stops
the communication process. Stating to the client
that he or she has not lost any weight implies
disbelief and does not explore the reasons for the
client’s failure to lose weight. “Testing” challenges
the client and is nontherapeutic.
Test-Taking Strategy: Use the process of
elimination and therapeutic communication
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techniques. Noting the words “working phase” in
the question will direct you to the correct option.
Review therapeutic communication techniques if
you had difficulty with this question.
Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
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