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

■ Suppression of appetite = weight loss, contraindicated for those who have

anorexia or bulimia

3. A nurse is assessing a client who has histrionic personality disorder. Which of the following findings

should the nurse expect?

A. Lack of remorse

B. Splitting of staff

C. Attention-seeking

D. Identity disturbance

Histrionic

● “POK POK” - Characterized by emotional attention-seeking behavior, in which the person needs to

be the center of attention; often seductive and flirtatious