A charge nurse is observing a newly licensed nurse provide care for a client who is postoperative.

The newly licensed nurse tells the client that she will insert a urinary catheter if the client will not void.

Which of the following torts should the charge nurse identify as having occurred?

B) Speak in a neutral tone when addressing the client.

When creating a plan of care for a client with paranoid personality disorder who refuses to take their medication, it's essential to approach the client in a way that fosters trust and reduces anxiety. Speaking in a neutral, non-confrontational, and non-threatening tone can help build rapport and facilitate communication with the client.

The other options are not appropriate interventions:

A) Mixing medication with the client's food without their consent can be seen as a breach of trust and may worsen the client's paranoia.

C) Limiting the client's opportunities to socialize with others can lead to increased isolation and potentially exacerbate the client's paranoid tendencies.

D) Rotating staff members caring for the client may also contribute to feelings of mistrust and may not be conducive to establishing a therapeutic nurse-client relationship. Consistency in care can be more helpful for individuals with paranoid personality disorder.

The correct answer is: b. “Tighten your muscles before relaxing them when using muscle relaxation techniques.”

Rationale for Choice B: Progressive Muscle Relaxation (PMR) is a well-established technique used in stress management and relaxation therapy. It involves systematically tensing and then relaxing specific muscle groups throughout the body. By tensing the muscles first, individuals can become more aware of the contrast between tension and relaxation, thereby enhancing the relaxation response. This heightened awareness helps individuals recognize and release muscular tension more effectively, leading to deeper relaxation and stress relief.

Rationale for Choice A: Choice A suggests talking to someone admired as the first step in using mindfulness techniques to relax. However, mindfulness practices typically involve cultivating awareness of the present moment without judgment. While seeking support from others may be beneficial for stress management, it is not a foundational aspect of mindfulness practice. Mindfulness often entails individual introspection and observation of one's thoughts, feelings, and bodily sensations.

Rationale for Choice C: Choice C recommends breathing in through the mouth and out through the nose during deep breathing exercises. While there are various breathing techniques utilized in stress management, the typical recommendation for deep breathing exercises is to inhale through the nose and exhale through the mouth. Nasal breathing helps regulate the flow of air, optimizes oxygen exchange, and activates the parasympathetic nervous system, promoting relaxation and stress reduction.

Rationale for Choice D: Choice D proposes imagining a stimulating situation when practicing guided imagery. However, guided imagery is a relaxation technique that involves creating vivid mental images of calming and tranquil scenes, such as a serene beach or peaceful forest. The purpose of guided imagery is to evoke positive emotions, reduce stress, and induce a state of deep relaxation. Imagining stimulating situations may have the opposite effect, potentially increasing arousal and tension rather than promoting relaxation.

In summary, while all choices may have some relevance to stress management, Choice B is the most appropriate as it aligns with the established technique of Progressive Muscle Relaxation. Choices A, C, and D deviate from widely recognized relaxation methods and are therefore considered incorrect in this context.