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Zorluk: ZorCoping Mechanisms

A practical nurse (PN) is caring for a client admitted with a severe exacerbation of chronic obstructive pulmonary disease (COPD). The PN observes the client returning from the bathroom smelling strongly of cigarette smoke. The client states, "I only took two puffs because my roommate's television is incredibly loud and stressing me out. It is the only way I can calm my nerves in this place." Recognizing the client is using the defense mechanism of rationalization, which response by the PN is the MOST therapeutic?

  1. It sounds like the noise in your room is making it very difficult to rest. Let's explore some other ways to help you relax without smoking.Cevap
  2. B
    Why would you risk worsening your breathing by smoking when you are already in the hospital for a severe lung problem?
  3. C
    You should not blame your roommate's television for your decision to violate the facility's strict no-smoking policy.
  4. D
    Try not to worry about it this time, but please remember that smoking is not allowed anywhere inside the hospital.

Cevap

The most therapeutic response validates the client's stress regarding the loud television and immediately offers to help find alternative, healthy relaxation methods.
The correct response utilizes the therapeutic techniques of acknowledging the client's feelings (frustration with the noise) and offering self to help problem-solve. By redirecting the conversation toward alternative relaxation methods, the practical nurse addresses the underlying anxiety and encourages adaptive coping without validating the harmful behavior of smoking.

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1
Identify the defense mechanism the client is using.
The client is using rationalization by providing a plausible, socially acceptable excuse (the loud television) to justify an unacceptable or harmful behavior (smoking with severe COPD).
Understanding the defense mechanism helps the nurse realize the client is attempting to manage underlying stress and anxiety, rather than just deliberately breaking rules.
2
Evaluate the nurse's goal in responding to maladaptive coping.
The practical nurse must address the underlying emotion (stress) without validating or accepting the harmful behavior, while reinforcing healthy coping strategies.
Confrontation usually increases defensive behavior, whereas validation of feelings builds trust and opens the door for education.
3
Analyze the options to eliminate non-therapeutic communication blocks.
Eliminate the options that ask 'why' (defensive), act as an authoritarian/judge (confrontational), or minimize the behavior (false reassurance).
Non-therapeutic blocks shut down communication and prevent the client from learning adaptive coping skills.
4
Select the response that demonstrates therapeutic communication.
The correct action acknowledges the stressor (loud room) and collaboratively offers to explore healthier relaxation techniques.
This falls perfectly within the PN scope of reinforcing education and promoting safe, adaptive coping mechanisms.

Anahtar Kavram

Therapeutic Communication and Adaptive Coping
Tahmini Süre:1m 30s
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Coping Mechanisms

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