A client admitted with cancer is scheduled for surgery. When the nurse enters the room, the client says, "I'm not having surgery — you must have the wrong person! My test results were negative. I'll be going home tomorrow." The nurse identifies this as which defense mechanism?

• A. Denial
• B. Projection
• C. Regression
• D. Rationalization

Answer: (A)

Denial is a defense mechanism in which a person refuses to accept distressing reality. Here, the client is facing cancer and a planned surgery but rejects that reality by saying the nurse has the wrong person, insisting test results were negative, and claiming they’ll go home. This refusal to acknowledge the diagnosis and the need for treatment serves to shield the client from overwhelming anxiety in the moment. It’s a common, protective reaction early in illness as the person processes difficult information. The nurse can respond with calm, supportive communication, provide clear information, and assess understanding while respecting the patient’s pace. This behavior isn’t about attributing feelings to someone else (projection), returning to childlike behavior (regression), or offering a logical excuse to justify the situation (rationalization), making denial the best-fitting explanation here.