Question

The client with a myocardial infarction comes to the nurse's station stating that he is ready to go home because there is nothing wrong with him. Which defense mechanism is the client using? A. Rationalization B. Denial C. Projection D. Conversion reaction

Short answer

A) Rationalization B) Denial C) Projection D) Conversion Reaction Answer: B) Denial

Step-by-step solution

Define Rationalization

Rationalization is a defense mechanism in which an individual justifies or excuses their actions or beliefs to reduce the anxiety caused by inconsistencies between their thoughts and actions. In this case, it would involve the client creating some justification for their belief that there is nothing wrong with them.

Define Denial

Denial is a defense mechanism in which an individual refuses to accept a reality or fact, essentially ignoring it, as a means of reducing distress and anxiety. In this case, the client would be denying that there is a problem even though they have had a myocardial infarction.

Define Projection

Projection is a defense mechanism in which an individual attributes their own undesirable thoughts or feelings onto someone else. In this situation, the client would be projecting their own feelings of being unwell onto someone else instead of admitting that they are experiencing an issue themselves.

Define Conversion Reaction

Conversion reaction is a defense mechanism in which emotional or mental distress is converted into physical symptoms, sometimes with no clear medical cause. In this situation, the client would be manifesting physical symptoms unrelated to their myocardial infarction as a way of avoiding acknowledging the issue.

Identify the Defense Mechanism

The appropriate defense mechanism in this case is Denial, as the client is refusing to accept that there is something wrong with them despite suffering a myocardial infarction. They are stating that they are ready to go home because there is nothing wrong with them, which clearly indicates denial. Therefore, the correct answer is: B. Denial

Key concepts

Denial

Denial is a powerful and often unconscious defense mechanism. It helps protect individuals from facing uncomfortable truths or realities. When someone is in denial, they refuse to accept the existence of a problem or its consequences.
For instance, a person having had a serious heart event like a myocardial infarction might insist there's nothing wrong. This stance allows them to avoid dealing with their fear or anxiety about their health.

• Denial can be temporary, fluctuating until the person gradually starts exploring their real feelings.
• It might serve as an initial coping strategy, buying time to process overwhelming emotions.

Eventually, however, persistent denial can hinder recovery, since it prevents the person from taking necessary steps to address their health issues.

Rationalization

Rationalization as a defense mechanism involves creating logical explanations to justify behavior that might otherwise be perceived as unacceptable or unreasonable. It's a way of easing the conflict between our moral standards and human impulses.
For example, after a myocardial infarction, someone might rationalize their condition by blaming it on temporary stress or dismiss it as something everyone experiences, thus lessening the need to change their lifestyle.

• Rationalization can preserve self-esteem by offering excuses that distance thinking from uncomfortable truths.
• This mechanism can mask underlying issues that need attention, making it harder to pursue genuine change.

Recognizing and being aware of rationalizations can be the first step towards healthier psychological processing.

Myocardial Infarction

A myocardial infarction is commonly known as a heart attack. It occurs when blood flow to a part of the heart is blocked, often by a blood clot. This blockage can cause damage or kill parts of the heart muscle due to lack of oxygen.
Symptoms of a myocardial infarction can include chest pain, shortness of breath, and a feeling of doom, among others. However, the presentation can vary between individuals.

• This condition requires immediate medical attention since timely intervention can save heart muscle and limit damage.
• Lifestyle changes and medication often follow the initial treatment to prevent future occurrences.

Understanding the seriousness of a myocardial infarction is crucial for effective treatment and recovery, and overcoming denial could be significant in acknowledging the necessary lifestyle changes.