Nurs 222 Quiz 4 Wk 4
Q4: ATI Review Modules (complete application exercise at the end of the chapter)
• Ch. 4
• Ch. 9
• Ch. 11
• Ch. 21
• Ch. 29
• Ch. 32
• Ch. 33
Ch 4:
Stress results from change in one’s environment that is threatening. Stress=anxiety.
Individuals se defense mechanism as a way to manage conflict in response to anxiety.
I. Defense mechanisms are reversible and may be used either adaptive or maladaptive
Adaptive mechanism
• Helps people to achieve their goals in acceptable ways
• Reduce anxiety
Maladaptive mechanism
• Interfere with functioning, relationships, and orientation to reality.
• Used in excess
*healthy forms of defense mechanism are Altruism and sublimination.
Forms of defense mechanisms:
a. Altruism: dealing with anxiety by reaching out to others
Adaptive: A nurse who lot a family member in a fire and is now a voluntary firefighter.
Maladaptive: n/a
b. Sublimination: dealing with unacceptable feeling or impulses by unconsciously substituting
acceptable forms of expression.
Adaptive: a person who has feelings of anger towards a boss takes out their aggression on
working out (not physical towards others only on self. = no kicking, punching, etc.,)
Maladaptive: n/a
c. Suppression: voluntary denying unpleasant thoughts and feelings.
Adaptive: A student puts off thinking about an argument or fight they had earlier with a friend
so they could focus on a test.
Maladaptive: a person who has lost their job states they will worry about paying next weeks bills
d. Repression: unconsciously putting unacceptable ideas, thoughts, and emotions out of
awareness.
Adaptive: person preparing to give a speech UNCONCIOUSLY forgets about the time they were
young and kids laughed at them on stage (good).
,Nurs 222 Quiz 4 Wk 4
Maladaptive: a person who fears going to the dentist continually forgets to go to their scheduled
dentist appointments.
e. Displacement: shifting feelings relating to an object, person, or situation to another less
threatening object, person, situation. (physical).
adaptive: A teen angrily punches his punching bag after losing the football game.
Maladaptive: A person who is angry about losing their job destroys his child’s favorite toy.
f. Reaction formation: unacceptable feelings or behaviors are controlled or kept out of awareness
by overcompensating or demonstrating. Over compensating or demonstrating is the opposite of
what is truly felt.
Adaptive: a person is trying to quit smoking repeatedly talks to adolescents of the dangers of
nicotine.
Maladaptive: person who resents having to care for an aging parent becomes overprotective
and restricts their freedom.
BREAK (take a breath because shit is still going)
g. undoing: performing an act to make up for prior behavior (most commonly seen in children).
Adaptive: an adolescent completes their chores without being prompted after having an
argument with their parent.
Maladaptive: individuals buy their significant other flowers and gifts after an incident of partner
abuse.
h. Rationalization: creating reasonable and acceptable explanation for unacceptable behavior.
Adaptive: when a teen says “they must have a boyfriend already” when rejected by another
teen.
Maladaptive: a young adult explains they had to drive home from a party after being drunk and
states he had to drive back home to feed his dog.
i. Dissociation: a disruption in consciousness, memory, identity or perception of the environment
that results in compartmentalization of uncomfortable or unpleasant aspect of one self.
Adaptive: a parent blocks out the distracting noise of their children in order to focus while
driving in traffic
Maladaptive: a person forgets who they are following a sexual assault.
j. Denial: pretending the truth is not reality to manage unpleasant anxiety causing thoughts or
feelings.
Adaptive: a person initially says “no that cant be true” when they are diagnosed with cancer.
Maladaptive: a parent whose child was killed in combat tells everyone one month later her son
is coming back home for the holidays.
k. Compensation: emphasizing strengths to make up for weaknesses.
Adaptive: an adolescent who is physically unable to play spots excels in academic competitions.
, Nurs 222 Quiz 4 Wk 4
Maladaptive: a person who is shy learns computer skills to avoid socialization.
l. Identification: conscious or unconscious assumption of the characteristics of another individual
or group.
Adaptive: a child who has a chronic illness at a hospital pretend to be a nurse for their dolls.
Maladaptive: a child who observes their parent being abusive towards the other parent
becomes a bully at school.
m. Intellectualization: separation of emotions and logical facts when analyzing or coping with a
situation or event.
Adaptive: a law enforcement officer blocks out the emotional aspect of a crime so they can
objectively focus on the investigation.
Maladaptive: a person learns they have a terminal illness focuses on creating a will and financial
matters rather than acknowledging their grief.
n. Conversion: responding to stress through the unconscious development of physical
manifestations not caused by a physical illness.
Adaptive: n/a
Maladaptive: a person experience deafness after their partner tells them that they want a
divorce.
o. Splitting: demonstrating an inability to reconcile negative and positive attributes of self or others
into a cohesive image.
Adaptive: n/a
Maladaptive: client tells a nurse that the nurse is the only one who cares about them, yet
following day, refused to talk to the same nurse.
p. Projection: attributing one’s unacceptable thought and feelings onto another who does not have
them.
adaptive use: n/a
maladaptive: a married client who is attracted to another person accuses their partner of having
an extramarital affair.
II. Anxiety levels:
a. Normal anxiety: healthy anxiety is anxiety that is necessary for survival, and
motivates people to take action.
(ex: a nurse moves in to defuse a situation between two patients in a psych unit and
the anxiety experienced by the nurse is normal.
b. Acute anxiety (immediate state): level of anxiety is precipitated by an imminent loss
or change that threatens one’s sense of security.
(ex: sudden death of a loved one or noticing being followed by a stalker will cause
immediate/acute anxiety.
Q4: ATI Review Modules (complete application exercise at the end of the chapter)
• Ch. 4
• Ch. 9
• Ch. 11
• Ch. 21
• Ch. 29
• Ch. 32
• Ch. 33
Ch 4:
Stress results from change in one’s environment that is threatening. Stress=anxiety.
Individuals se defense mechanism as a way to manage conflict in response to anxiety.
I. Defense mechanisms are reversible and may be used either adaptive or maladaptive
Adaptive mechanism
• Helps people to achieve their goals in acceptable ways
• Reduce anxiety
Maladaptive mechanism
• Interfere with functioning, relationships, and orientation to reality.
• Used in excess
*healthy forms of defense mechanism are Altruism and sublimination.
Forms of defense mechanisms:
a. Altruism: dealing with anxiety by reaching out to others
Adaptive: A nurse who lot a family member in a fire and is now a voluntary firefighter.
Maladaptive: n/a
b. Sublimination: dealing with unacceptable feeling or impulses by unconsciously substituting
acceptable forms of expression.
Adaptive: a person who has feelings of anger towards a boss takes out their aggression on
working out (not physical towards others only on self. = no kicking, punching, etc.,)
Maladaptive: n/a
c. Suppression: voluntary denying unpleasant thoughts and feelings.
Adaptive: A student puts off thinking about an argument or fight they had earlier with a friend
so they could focus on a test.
Maladaptive: a person who has lost their job states they will worry about paying next weeks bills
d. Repression: unconsciously putting unacceptable ideas, thoughts, and emotions out of
awareness.
Adaptive: person preparing to give a speech UNCONCIOUSLY forgets about the time they were
young and kids laughed at them on stage (good).
,Nurs 222 Quiz 4 Wk 4
Maladaptive: a person who fears going to the dentist continually forgets to go to their scheduled
dentist appointments.
e. Displacement: shifting feelings relating to an object, person, or situation to another less
threatening object, person, situation. (physical).
adaptive: A teen angrily punches his punching bag after losing the football game.
Maladaptive: A person who is angry about losing their job destroys his child’s favorite toy.
f. Reaction formation: unacceptable feelings or behaviors are controlled or kept out of awareness
by overcompensating or demonstrating. Over compensating or demonstrating is the opposite of
what is truly felt.
Adaptive: a person is trying to quit smoking repeatedly talks to adolescents of the dangers of
nicotine.
Maladaptive: person who resents having to care for an aging parent becomes overprotective
and restricts their freedom.
BREAK (take a breath because shit is still going)
g. undoing: performing an act to make up for prior behavior (most commonly seen in children).
Adaptive: an adolescent completes their chores without being prompted after having an
argument with their parent.
Maladaptive: individuals buy their significant other flowers and gifts after an incident of partner
abuse.
h. Rationalization: creating reasonable and acceptable explanation for unacceptable behavior.
Adaptive: when a teen says “they must have a boyfriend already” when rejected by another
teen.
Maladaptive: a young adult explains they had to drive home from a party after being drunk and
states he had to drive back home to feed his dog.
i. Dissociation: a disruption in consciousness, memory, identity or perception of the environment
that results in compartmentalization of uncomfortable or unpleasant aspect of one self.
Adaptive: a parent blocks out the distracting noise of their children in order to focus while
driving in traffic
Maladaptive: a person forgets who they are following a sexual assault.
j. Denial: pretending the truth is not reality to manage unpleasant anxiety causing thoughts or
feelings.
Adaptive: a person initially says “no that cant be true” when they are diagnosed with cancer.
Maladaptive: a parent whose child was killed in combat tells everyone one month later her son
is coming back home for the holidays.
k. Compensation: emphasizing strengths to make up for weaknesses.
Adaptive: an adolescent who is physically unable to play spots excels in academic competitions.
, Nurs 222 Quiz 4 Wk 4
Maladaptive: a person who is shy learns computer skills to avoid socialization.
l. Identification: conscious or unconscious assumption of the characteristics of another individual
or group.
Adaptive: a child who has a chronic illness at a hospital pretend to be a nurse for their dolls.
Maladaptive: a child who observes their parent being abusive towards the other parent
becomes a bully at school.
m. Intellectualization: separation of emotions and logical facts when analyzing or coping with a
situation or event.
Adaptive: a law enforcement officer blocks out the emotional aspect of a crime so they can
objectively focus on the investigation.
Maladaptive: a person learns they have a terminal illness focuses on creating a will and financial
matters rather than acknowledging their grief.
n. Conversion: responding to stress through the unconscious development of physical
manifestations not caused by a physical illness.
Adaptive: n/a
Maladaptive: a person experience deafness after their partner tells them that they want a
divorce.
o. Splitting: demonstrating an inability to reconcile negative and positive attributes of self or others
into a cohesive image.
Adaptive: n/a
Maladaptive: client tells a nurse that the nurse is the only one who cares about them, yet
following day, refused to talk to the same nurse.
p. Projection: attributing one’s unacceptable thought and feelings onto another who does not have
them.
adaptive use: n/a
maladaptive: a married client who is attracted to another person accuses their partner of having
an extramarital affair.
II. Anxiety levels:
a. Normal anxiety: healthy anxiety is anxiety that is necessary for survival, and
motivates people to take action.
(ex: a nurse moves in to defuse a situation between two patients in a psych unit and
the anxiety experienced by the nurse is normal.
b. Acute anxiety (immediate state): level of anxiety is precipitated by an imminent loss
or change that threatens one’s sense of security.
(ex: sudden death of a loved one or noticing being followed by a stalker will cause
immediate/acute anxiety.
