Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?

Correct Answer: A

Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.

Correct Answer: B

Rationale: The correct answer is B: Projection. The nurse should determine that the client's statement reflects the defense mechanism of projection. Projection refers to the attribution of one's unacceptable feelings or impulses to another person. In this case, the boy is projecting his own desires onto the female teacher, believing that she wants him. By externalizing his feelings, the boy reduces his anxiety and discomfort about his own attraction. Displacement involves transferring emotions from one target to another, not attributing one's own feelings to others. Rationalization involves creating logical explanations for unacceptable behaviors, not projecting feelings onto others. Sublimation is the channeling of unacceptable impulses into socially acceptable actions, which is not demonstrated in this scenario.

Correct Answer: C

Rationale: The professional should identify that the student is using reaction formation as a defense mechanism. Reaction formation involves expressing opposite thoughts or behaviors to prevent undesirable thoughts from being expressed. In this scenario, the student's teasing and joking behavior towards the girl can be seen as a way to cover up or mask his true feelings or desires towards her. Displacement involves redirecting emotions from the original source to a substitute target; Projection involves attributing one's undesirable feelings to others; Sublimation involves channeling unacceptable impulses into socially acceptable activities. Therefore, in this case, the student's behavior aligns most closely with reaction formation.

Correct Answer: B

Rationale: Neurosis involves feelings of distress and anxiety, but individuals experiencing neurosis are usually aware of their distress and its causes. They may recognize that their behaviors are maladaptive and are generally in contact with reality. The accurate statement about neurosis is that an individual feels helpless to change their situation. Choice A is incorrect because individuals with neurosis are usually aware of their distress. Choice C is incorrect because while individuals may be aware of psychological causes, it is not the defining characteristic of neurosis. Choice D is incorrect because a loss of contact with reality is more characteristic of psychosis, not neurosis.

Correct Answer: B

Rationale: The most accurate statement about psychoses is that individuals experiencing it often exhibit limited distress because they are not fully aware of their altered perception of reality. They may not recognize that their behaviors are maladaptive or acknowledge the presence of psychological issues. Choice A is incorrect because individuals with psychoses may not be aware that their behaviors are maladaptive. Choice C is incorrect because individuals with psychoses may not have insight into their psychological problems. Choice D is incorrect because individuals with psychoses often struggle to differentiate between reality and their altered perceptions.