NCLEX-PN

A.​ Suppression B.​ Repression C.​ Denial D.​ Displacement Correct Response: A

Explanation: The correct answer is (A) , as the client is exhibiting suppression. Suppression involves the conscious and intentional blocking of unwanted thoughts or urges, and in this case, the client purposely avoids discussing the boating accident with his mother by reassuring her that everything is fine. This defense mechanism allows individuals to cope with overwhelming thoughts by actively pushing them out of conscious awareness. (B) Repression, on the other hand, involves a subconscious process of blocking unwanted memories, making it distinct from the client's conscious effort to suppress thoughts of the accident. While (C) denial is a common defense mechanism characterized by refusing to accept reality, the client is not outright denying the accident but rather consciously avoiding discussing it. (D) Displacement, the redirection of emotions to a less threatening target, is not evident in the client's response. Recognizing the use of suppression informs appropriate therapeutic approaches and support to help the client cope with the traumatic event. (See Coping Mechanisms ) 12. The LPN collects this set of vital signs from the client: Pulse 67, Blood Pressure 167/89, Temperature 96.2 F, Pulse Ox 98%. What would be the most appropriate next action?

A.​ Apply a warm blanket. B.​ Administer Metoprolol. C.​ Contact the primary healthcare provider. D.​ Review the client’s chart. Correct Response: D

Explanation : The correct answer is (D) Review the client’s chart. The LPN should carefully examine the client's chart to determine whether the recorded vital signs, including a pulse of 67, blood pressure of 167/89, temperature of 96.2°F, and pulse oximetry of 98%, are within the client's baseline. Understanding the client's typical vital sign ranges is crucial before deciding on any interventions, as elevated readings may be normal for that individual. Applying a warm blanket (A) is not the most appropriate action as it does not directly address the potential hypertension indicated by the elevated blood pressure. Administering Metoprolol (B) without a comprehensive assessment may not be warranted, and contacting the primary healthcare provider (C) should be based on a more informed understanding of the client's baseline. Reviewing the client’s chart allows for a comprehensive assessment before deciding on any specific interventions. (See Monitoring Client Output: Detecting Changes from Baseline )

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