Which comment by the patient indicates use of a maladaptive or ...

[notis]

Which comment by the patient indicates use of a maladaptive or ineffective coping strategy?
 
  a. That heart attack was no fun, but at least it woke me up to my need for a better diet and more exercise..
  b. My family and God will see me through this. It won't be easy, but I'll never be alone..
  c. I definitely have cancer. Now I need to look at the effects of treatment and decide whether I will be able to work daily..
  d. I wouldn't be in this position if the company had better health benefits. If they paid for health club memberships, maybe I wouldn't be here now..

Question 2

A factory abruptly closes. An office worker initially tries to take it in stride, begins the job search, and networks with peers. Five weeks later, he has not received a single call-back from a prospective employer.
 
  He cannot sleep, is irritable, does not want to interact with his family or peers, paces, and spends several hours most days alone in a local bar. He has given up applying for jobs. Which three nursing diagnoses would be the highest priority at this time? Select all that apply. a. Risk for self-injury
  b. Risk for compromised resilience
  c. Ineffective denial
  d. Ineffective coping
  e. Chronic low self-esteem
  f. Social isolation

[ApricotDream]

Answer to Question 1

D
Blaming someone else and rationalizing one's failure to exercise are not usually considered to be adaptive coping strategies. Seeing the glass as half full, using social and religious supports, and confronting one's situation are seen as more effective strategies.

Answer to Question 2

A, D, F
The fact that the person is no longer making adaptive efforts to cope suggests hopelessness. Withdrawal, irritability, and impaired sleep suggest possible depression. The depression, hopelessness, alcohol abuse, and isolation are risk factors for suicide, so Risk for self-injury is the highest-priority diagnosis. The root cause of his current status is that his systems for coping have been overwhelmed, making Ineffective coping the second priority after safety. Risk for compromised resiliency is not a priority relative to other concerns, and the data do not support Ineffective denial or Chronic low self-esteem. Social isolation is clearly a concern because of his withdrawal and lack of access to supports, so it is also a top-three priority.