A 45-year-old man with a history of anxiety comes into the emergency department and is diagnosed with a myocardial infarction (MI).He says to the nurse,"This is the most ridiculous thing I've ever heard of.I eat well,exercise,and am too young to have a heart attack." The nurse recognizes that this man is most likely experiencing:

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Ineffective denial occurs when a person consciously or unconsciously rejects the knowledge or meaning of an event such as having a heart attack.The patient may frequently respond with statements such as "This can't be me," "They've made a mistake." In this item,the man is denying he has had a heart attack because he believes he is too healthy and too young to be having a heart attack.Fear is a response associated with anxiety; however,it is usually a response to a perceived threat that is recognized as a danger.Decisional conflict arises when a person is uncertain about what action to take when making choices among alternatives.There is no evidence in this item that the man is making any decisions.Overreaction can occur with some psychosocial disorders; however,the patient statements are not reflective of overreacting,as he has been diagnosed as having a heart attack.

A 45-Year-Old Man with a History of Anxiety Comes into the Emergency