NVS Staff Nurse - 2019
Mental Health Nursing
Hard
A patient addicted to drugs says, 'everyone I know is using cocaine. Why shouldn't I? This is an example of?
Appeared in: NVS Staff Nurse - 2019
Explanation
- The patient's statement, "everyone I know is using cocaine. Why shouldn't I?" is a classic example of a defense mechanism used to cope with the anxiety of addiction.
- This statement is a form of rationalization, where the patient creates a logical-sounding excuse to justify their behavior.
- This rationalization serves the broader defense of Denial. By normalizing the behavior, the patient denies the severity and personal consequences of their addiction.
- According to psychiatric texts, denial is a failure to appreciate the personal significance or implications of a situation, which is exactly what the patient is demonstrating.
Why Other Options Were Wrong
- Option B: Projection involves blaming others or attributing one's own unacceptable feelings to someone else. The patient is justifying their own actions, not blaming others for their desire to use drugs.
- Option C: Regression is a retreat to an earlier, more childlike pattern of behavior under stress. The patient's statement is a cognitive justification, not a behavioral regression.
- Option D: Intellectualization involves using detached, abstract, and unemotional reasoning to avoid feelings. The patient's statement is a personal excuse, not a detached academic analysis. While related to rationalization, it lacks the key element of emotional distance.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Defense Mechanisms in Mental Health Nursing to guide bedside assessment, documentation, and the next nursing action.
- Recognizing defense mechanisms is crucial for nurses to understand a patient's psychological state and resistance to treatment.
- When a patient uses denial or rationalization, direct confrontation is often ineffective. Instead, nurses should use motivational interviewing techniques to gently explore the discrepancies between the patient's beliefs and the reality of their situation.
- Patient Safety: A patient in denial about their addiction is at high risk for overdose and other complications because they cannot accurately assess the danger of their behavior.
How to Approach the Question
- First, identify the core of the patient's statement. The patient is making an excuse or justification for their drug use.
- Recall the definitions of the common defense mechanisms provided in the options.
- The most accurate term for 'making an excuse' is Rationalization. Check if it is an option.
- Since Rationalization is not an option, evaluate which of the given options best encompasses the patient's statement. The excuse ('everyone does it') serves to minimize and deny the severity of the problem.
- Compare the remaining options. The statement is a direct manifestation of the patient's Denial of their problem's significance. It is not Projection (blaming), Regression (childlike behavior), or Intellectualization (detached analysis).
Concept Tested & Keywords
- Concept Tested: Defense Mechanisms in Mental Health Nursing
- Stem keywords: addicted to drugs, everyone I know is using cocaine, defense mechanism
- Lead-in keywords: example of
Question ID
Q3oyZTYKM9JyXDm6TCY5LA
Reference Book
E6 Psychology Morgan King 9e Part 2 p. 187-189
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 6865-6867
Practise the full NVS Staff Nurse - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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