A client prescribed sertraline for depression is receiving discharge instructions. Which statement by the client indicates an accurate understanding of the medication?

Correct Answer: D

Rationale: The correct answer is D because sertraline, used for depression, typically takes several weeks to become effective. It is important for clients to understand this delayed onset of action to manage their expectations and continue taking the medication as prescribed despite not seeing immediate results.

Correct Answer: A

Rationale: The correct answer is A. Clients should avoid alcohol while taking diazepam (Valium) as it can potentiate the effects of the medication, leading to excessive sedation and other adverse effects. Mixing alcohol with diazepam can also increase the risk of overdose and other serious complications. Therefore, it is crucial for the client to refrain from consuming alcohol while on this medication to ensure their safety and optimize the therapeutic benefits of diazepam for managing anxiety.

Correct Answer: B

Rationale: Displacement is a defense mechanism in psychology where an individual redirects their emotions, impulses, or frustrations from their original, often threatening or unacceptable source toward a substitute target that is safer or more accessible. This redirection helps alleviate anxiety but can manifest in harmful ways if the substitute is innocent or unrelated. Now, let's examine the choices step by step to understand why B exemplifies displacement clearly, while the others align with different mechanisms. First, consider choice B: A woman yells at her children after a stressful day at work. This is a textbook example of displacement because the woman's stress and frustration originate from her workplace—likely a source she can't confront directly due to power dynamics, job security fears, or social norms. Instead, she redirects her pent-up aggression toward her children, who are a safer, more immediate target at home. This substitution allows her to release tension without addressing the real issue, but it unfairly burdens those closest to her. The mechanism here is purely redirective: the emotional energy from work is displaced onto family, not transformed or sublimated into something productive. In contrast, choice A: A man kicks his dog after an argument with his boss, appears similar at first glance but is not the best fit for displacement in this context because it represents an even more impulsive and direct outlet, often classified under acting out rather than true displacement. While it involves redirection from boss to pet, the action is too visceral and lacks the emotional buildup of a "stressful day," making it more akin to immediate aggression spillover. Displacement typically involves a buildup of unresolved tension, as in B, whereas A feels like raw, unfiltered lashing out without the protective redirection intent. Choice C: A student immerses herself in studying to avoid thinking about a recent breakup, illustrates intellectualization or denial through distraction, not displacement. Here, the student is avoiding the painful emotions of the breakup by channeling energy into a productive activity—studying—which serves as a substitute focus but doesn't redirect the emotions aggressively or harmfully toward another target. Instead, it's a form of repression or sublimation, where the breakup anxiety is buried under academic pursuits, allowing indirect coping without substituting one object of emotion for another. Finally, choice D: A person channels aggressive impulses into playing a sport, demonstrates sublimation, a mature defense mechanism where unacceptable impulses (like aggression) are redirected into socially acceptable and constructive outlets, such as athletics. Unlike displacement, which often targets innocent bystanders and can be maladaptive, sublimation transforms the raw energy into something beneficial, like physical exercise that builds skills or relieves stress positively. The key difference is that sublimation elevates the impulse rather than just shifting it downward to a weaker target. By comparing these, B stands out as displacement because it involves harmful redirection from an unattainable source (work stress) to a vulnerable one (children), without the productive transformation seen in D or the avoidance in C. Understanding displacement helps students recognize how unaddressed emotions can strain relationships, emphasizing the need for healthier coping strategies like direct communication or therapy to confront root causes. This mechanism, first described by Freud, underscores why redirecting frustration often perpetuates cycles of emotional harm if not managed mindfully.

Correct Answer: B

Rationale: For a client experiencing severe anxiety, the primary goal of intervention is to reduce immediate distress and promote safety by minimizing external stimuli that could exacerbate the symptoms. Providing a quiet and calm environment, as in option B, is the most appropriate initial intervention because severe anxiety often involves heightened physiological arousal, such as rapid heartbeat, hyperventilation, and sensory overload. A serene setting helps lower sensory input, allowing the client's nervous system to downregulate naturally. This aligns with evidence-based practices like those from the American Psychiatric Association, which recommend de-escalation through environmental control for acute anxiety episodes. By dimming lights, reducing noise, and ensuring privacy, the healthcare professional creates a space for the client to regain composure without added pressure, preventing escalation to panic or crisis. In contrast, option A—encouraging the client to talk about their feelings—may be beneficial in therapeutic settings for processing emotions during milder anxiety or post-acute phases, but it's unsuitable for severe anxiety. At this intensity, verbal expression can feel overwhelming or impossible due to cognitive fog or racing thoughts, potentially increasing agitation rather than alleviating it. Therapeutic talking is more appropriate after stabilization, as forcing it prematurely could heighten vulnerability and lead to emotional flooding. Option C—encouraging vigorous exercise—is counterproductive for severe anxiety because it can mimic or intensify the physical symptoms of anxiety, such as elevated heart rate, sweating, and adrenaline surges, confusing the client's body signals and worsening the panic response. While moderate exercise aids long-term anxiety management by releasing endorphins, vigorous activity during an acute severe episode risks physical exhaustion or injury, especially if the client is already breathless or disoriented. Guidelines from the National Institute for Health and Care Excellence (NICE) advise against high-intensity interventions in acute states, favoring rest instead. Option D—encouraging participation in group activities—introduces social pressures and interpersonal dynamics that could amplify anxiety for someone in severe distress, as it involves exposure to multiple people, noise, and expectations of interaction. This might trigger social anxiety components or feelings of inadequacy, leading to withdrawal or further isolation. Group interventions are valuable for building support networks in recovery phases but are contraindicated initially when the client needs individualized calming to rebuild a sense of control. Overall, selecting B prioritizes immediate safety and physiological relief, forming the foundation for subsequent interventions like those in A, C, or D once the severity subsides. This step-by-step approach ensures ethical, client-centered care rooted in crisis intervention principles.

Correct Answer: A

Rationale: During a panic attack, the immediate priority for the nurse is to provide support and reassurance to the client. Remaining with the client helps establish a sense of safety and trust, which can help calm the client during an episode of panic. Administering medication, encouraging physical activity, and deep breathing techniques are beneficial interventions, but offering reassurance and support should be the initial step to address the immediate emotional distress and anxiety experienced by the client.