The nurse is caring for a client in the psychiatric unit who has issues with coping and defense mechanisms. The nurse understands that which is true regarding coping and defense mechanisms?

Select all that apply.
  1. Coping mechanisms are destructive ways to avoid dealing with reality.
  2. Physical symptoms, general irritability, and self-destructive behaviors are some of the signs of inadequate coping.
  3. Criticizing ineffective defense mechanisms will guide the client toward better coping techniques.
  4. Ineffective coping mechanisms allow anxiety to increase, triggering the client to utilize defense mechanisms in order to protect himself from the anxiety.
  5. The inability to cope can be caused by a lack of an adequate support system, a serious medical diagnosis, situational crises, or a lack of psychological resources.
Numbers 2, 4, and 5 are correct.
Rationale: Inadequate coping can manifest with physical symptoms, general irritability, and destructive behavior toward self or others. The client may or may not be able to verbalize the inability to cope. When coping mechanisms fail, anxiety can trigger defense mechanisms to protect the self. Inadequate coping can be caused by a number of factors. Lack of a family or social support system, serious medical diagnoses, crisis situations, and lack of psychological resources contribute to the inability to cope. Coping mechanisms are not always destructive; many coping mechanisms are positive and allow the individual to effectively manage stress. The nurse should not criticize the client’s defense mechanisms that are not effective. Instead, the nurse should suggest ways to develop better defense mechanisms and work with the client to enhance and reinforce those skills. The nurse must be aware of which coping and defense mechanisms the client uses in order to develop a suitable plan of care.