Chapter7:CopingandDefense MechanismsMyNursingTestBanks

Chapter 7: Coping and Defense Mechanisms

Multiple Choice

Identify the choice that best completes the statement or answers the question.

1. Your patient is sternly criticized by her doctor for not complying with the medication regimen. The patient walks out of the office and yells at the parking attendant. This may be an example of which defense mechanism?

A. Projection

B. Intellectualization

C. Reaction formation

D. Displacement

2. Which of the following best describes what defense mechanisms are?

A. Abnormal coping mechanisms

B. Genetically wired responses

C. Protective devices that reduce anxiety

D. All of the above

3. A new patient with schizophrenia is admitted to the psychiatric unit. He is standing at the locked exit door and yelling, Help me, I dont belong here. This behavior is most likely an example of what defense mechanism?

A. Denial

B. Regression

C. Enabling

D. Projection

4. Nurse Anne recognizes that John is always blaming others for his shortcomings. Finger pointing is usually related to the defense mechanism of:

A. Scapegoating.

B. Identification.

C. Restitution.

D. Avoidance.

5. Joy has just experienced her fifth spontaneous abortion. She is unable to understand why this is happening to her. Joy voices her anger toward her physician and the nurses, accusing them of incompetence. Assessing the situation, the nurse recognizes that the client may be using the coping mechanism of:

A. Conversion reaction.

B. Displacement.

C. Denial.

D. Regression.

6. Marion, a 25-year-old patient who lives with her parents, explains to the nurse at the community clinic, I really dont need to talk to anyone, even my parents. The patient expresses that she is too busy and does not have the time to sit and talk. The nurse recognizes that the client is most likely using the defense mechanism known as:

A. Conversion reaction.

B. Avoidance.

C. Isolation.

D. Denial.

7. Karen Ann, a patient on the mental health unit, is in the bathroom with the door locked. She was admitted to the unit as a result of her psychotic behavior. The mental health nurse is asking her to come out and take her medication. The patient responds by stating, There is nothing wrong with my behavior. I dont need any medication. I dont know why everyone is so upset. Her response indicates that the defense mechanism being used is:

A. Denial.

B. Obsession.

C. Displacement.

D. Projection.

8. Unconscious refusal to see reality describes this type of defense mechanism:

A. Denial.

B. Repression.

C. Compensation.

D. Isolation.

9. Use of a logical-sounding excuse to cover up true thoughts and feelings describes this defense mechanism:

A. Denial.

B. Rationalization.

C. Compensation.

D. Isolation.

10. Emotion that is separated from the original feeling describes this defense mechanism:

A. Denial.

B. Repression.

C. Compensation.

D. Isolation.

11. Anthony is a 40-year-old patient who lost his job recently and wishes that he was back home living with his parents. Anthony has been noted to do things he used to do when he was a child. Anthony is going through a period of regression. Regression is best defined as:

A. A retreat to a less stressful time in ones life.

B. An immature response technique.

C. An assertive response.

D. A therapeutic mechanism.

12. Your patient Vicky just received a diagnosis of terminal cancer. You plan to speak to her about her response to the diagnosis.. When you reach her room, you find Vicky on the phone. As youre standing in the doorway, she starts laughing. You are startled when she states, Why are you looking so sad? Obviously the tests were wrong. I am not that sick. The patient is displaying:

A. Transference.

B. Regression.

C. Denial.

D. Isolation.

13. Audrey, a mental health nurse, has noticed that every day prior to going to work, she starts off with headaches, loose stools, episodes of feeling light-headed, and other disorders. These symptoms may be an expression of emotional disturbances. Audrey is aware she could be experiencing:

A. Isolation.

B. Repression.

C. Splitting.

D. Conversion.

14. Lilas three-year-old daughter is an only child who recently started day care. It was only 6 months ago that Lila had toilet trained her daughter. After 1 week in the day care, her daughter has started wetting herself and crawling. Her mother has become quite concerned. The school nurse explained to her that her daughter probably is experiencing:

A. Regression.

B. Depression.

C. Manipulation.

D. Compensation.

15. An overweight male college student is unable to participate in competitive sports. Although he cant be a sports hero, the student becomes the life of the party when socializing. This student also uses his student loan to purchase a new sports car. The student is displaying:

A. Compensation.

B. Reaction formation.

C. Transference.

D. Identification.

16. One of the female patients on the mental health unit starts to have delusions of persecution and is hearing voices. Prior to this admission, she attempted several times to poison her boyfriend after the voices told her to do so. During your initial rounds, you enter her room and ask her how she is doing. The patient states, shes a bad person. Your patient is exhibiting:

A. Transference.

B. Aggression.

C. Dissociation.

D. Denial.

17. The charge nurse has been in a meeting with the director of nursing (DON). The DON has been given some very unpleasant mandates by administration, which came down to the charge nurse. It is now the charge nurses responsibility to disseminate these mandates to the nursing staff. When the charge nurse gives the news to the nursing staff, she gives it to them in a very harsh manner toward the staff. This is an example of:

A. Compensation.

B. Identification.

C. Displacement.

D. Reaction formation.

18. A patient who has survived a motor vehicle accident has just learned that the passenger in the car has died. The survivor is unable to recall being in the car. The nurse on duty realizes that this is:

A. Dissociation.

B. Denial.

C. Regression.

D. Transference. Completion

Complete each statement.

19. The patient yells at the nurse right after having a stressful conversation with his spouse. What defense mechanism is the patient most likely using?

20. is an unconscious burying or forgetting mechanism.

21. Using a logical-sounding excuse is known as .

22. The physically unattractive person who wants to model and instead becomes a famous designer is demonstrating .

23. A wellness instructor who lectures on love and happiness but who is actually an abusive husband is using the defense mechanisms of .

24. The student who fails her finals is told she is out of the nursing program. She goes home and verbally abuses family members. This type of behavior is known as .

25. I didnt get the position because the director doesnt like me is an example of the defense mechanism .

26. I can quit smoking any time I want to. The person is in .

27. A young married woman is attracted to a male coworker. To counteract these feelings, she tells the boss she cant work with him. The defense mechanism used here is .

28. is the way a person adapts to a stressor psychologically, physically, and behaviorally.

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

29. Defense mechanisms are methods used for reducing anxiety. Defense mechanisms unconsciously assist a person in handling stressful events in an effective manner. People have a group of defense mechanisms learned from childhood. The following are defense mechanisms (select all that apply):

A. Compensation.

B. Rationalization.

C. Depression.

D. Regression.

E. Denial.

30. Which of the following defense mechanisms do people typically use in times of stress (select all that apply):

A. Denial.

B. Bargaining.

C. Compensation.

D. Rationalization.

E. Acceptance.

Chapter 7: Coping and Defense Mechanisms

Answer Section

Multiple Choice

1. ANS: D

Displacement is transferring anger and hostility to another person or object that is perceived to be less powerful.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108-109

KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

Mental Health: Coping | Cognitive Level: Application | Client Need:

Psychosocial Integrity: Mental health concepts

2. ANS: C

Defense mechanisms are learned responses to anxiety that help us cope with stress. Though they can be maladaptive, they are not considered abnormal.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Defense Mechanisms; page 107

KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

Mental Health: Coping | Cognitive Level: Comprehension | Client Need:

Psychosocial Integrity: Mental health concepts

3. ANS: A

This patient is struggling to accept a painful reality. Denial serves as a way to avoid this reality. Regression is emotionally returning to an earlier time in life when there was far less stress. Projection is blaming others. Enabling is not a defense mechanism.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108-109

KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

Mental Health: coping | Cognitive Level: Application | Client Need:

Psychosocial Integrity: Coping mechanisms

4. ANS: A

Scapegoating is blaming others for ones own unacceptable behavior.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly

Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

5. ANS: B

Displacement is transferring anger and hostility to another person or object that is perceived less powerful.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Caring | Content Area: Mental Health: Defense Mechanism | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Coping Mechanisms

6. ANS: B

The person is avoiding situations that may open up feelings.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Defense Mechanisms | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Coping Mechanisms

7. ANS: A

Denial is unconscious refusal to see reality.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanism

8. ANS: A

Denial is the attempt to remove an experience or a feeling from consciousness.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly

Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

9. ANS: B

Rationalization is the most frequently used defense. It is substituting acceptable reasons for real reasons for personal behaviortruth is too threatening.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Coping Mechanisms

10. ANS: D

Isolation is the blocking of feelings that are associated with an unpleasant or threatening situation.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

11. ANS: A

During a stressful event, people may revert back to a time that was less stressful.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Comprehension

12. ANS: C

The patient is experiencing unconscious refusal to see reality that provides a protection from facing something so distressing.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application

13. ANS: D

The patients anxiety about going to work can be channeled into physical symptoms; once the anxiety of work is reduced, the physical symptoms disappear.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Caring | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanisms

14. ANS: A

The child is emotionally returning to an early time in her life when there was far less stress.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application

15. ANS: A

Compensation is making up for something we perceive as an inadequacy by developing some other desirable trait.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: coping | Cognitive Level: Application

16. ANS: C

The patient may be referring to herself in third person due to unacceptable feelings she is experiencing, so she disassociates from the emotion.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Analysis

17. ANS: C

Transferring anger and hostility to another person or object that is perceived to be less powerful is the definition of displacement. It is easier to display anger to her employees than her supervisor.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Analysis

18. ANS: A

Dissociation occurs when painful events or situations are separated from the conscious mind.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanisms

COMPLETION

19. ANS: Displacement

In displacement, feelings are transferred to a less threatening object.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Analysis | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping mechanism

20. ANS:

Repression;

Repression is the unconscious exclusion of painful impulses, desires, or fears from the conscious mind.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial

Integrity: Coping Mechanisms

21. ANS: rationalization

It is the most frequently used defense mechanism. It is often seen when a logical-sounding excuse is used to cover up true thoughts and feelings.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

22. ANS: compensation

Making up for something perceived as an inadequacy by developing some other desirable trait.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial

Integrity: Coping Mechanisms

23. ANS: sublimation

Unacceptable traits or characteristics are diverted into acceptable traits or characteristics.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental

Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

24. ANS: displacement; transference

Transferring anger and hostility to another person or object that is perceived to be less powerful.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

25. ANS:

Scapegoating

Scapegoating is unfairly blaming others. The origin of this term is from the Bible, which describes a ritual in which a goat is sent into the desert bearing the sins of the people of Israel.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental

Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

26. ANS: denial

Denial is usually the first defense learned and used. It is an unconscious refusal to see reality.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental

Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

27. ANS: avoidance

Unconsciously staying away from events or situations that might open feelings of aggression or anxiety.

Integrated Process: Teaching/Learning | Content Area: Mental Health; Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanisms

Ref. Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

28. ANS:

Coping

Coping is the ability to deal consciously with problems and stress.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Coping; page 105

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms

MULTIPLE RESPONSE

29. ANS: A, B, D, E

Defense mechanisms are used by all people and are not necessarily a sign of psychiatric disorder unless they are used excessively. The main purpose of defense mechanisms is to decrease anxiety.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Defense Mechanisms; Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Analysis | Client Need: Psychosocial

Integrity: Coping Mechanism

30. ANS: A, C, D

These are all commonly used defense mechanisms.

PTS: 1

REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Analysis