A nurse at an outpatient mental health facility is monitoring effective use of stress management techniques for a client who is attending stress management group therapy. Which of the following statements made by the client indicates effective use of cognitive reframing?

“I should try to focus on pleasant images to help replace stressful and negative feelings I have."

“I will use my smartwatch to monitor my sleep and heart rate to assist me with gaining voluntary control over my stress."

"I should reassess the situation and change my perceptions of stress by replacing irrational beliefs."

"I will tense my muscles for 8 seconds and then relax them to release the tension caused by my stress.”

Answer and Explanation

The Correct Answer is C

Rationale:

A. “I should try to focus on pleasant images to help replace stressful and negative feelings I have.”: This describes guided imagery, a relaxation technique that uses visualization to reduce stress. While helpful, it does not involve the cognitive restructuring.

B. “I will use my smartwatch to monitor my sleep and heart rate to assist me with gaining voluntary control over my stress.”: This reflects biofeedback, where physiological responses are tracked and managed through conscious control. It involves physical awareness, not cognitive reinterpretation of stress.

C. "I should reassess the situation and change my perceptions of stress by replacing irrational beliefs.”: This is cognitive reframing, a technique that helps clients identify and challenge distorted thinking and replace it with more rational, constructive thoughts to alter their emotional responses to stress.

D. "I will tense my muscles for 8 seconds and then relax them to release the tension caused by my stress.”: This refers to progressive muscle relaxation, which targets physical symptoms of stress rather than the cognitive processes addressed in cognitive reframing.

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Correct Answer is B

Explanation

Rationale:

A. The client's length of facility stay: The duration of a client’s admission does not determine the appropriateness of delegation. Delegation decisions are based on the client’s current condition and the nature of the task, not how long they have been in the facility.

B. The AP's job description: Verifying the AP’s job description ensures the task falls within their authorized scope of practice. It helps confirm that the AP has the appropriate training and legal authority to carry out the delegated activity safely and competently.

C. The AP's years of experience: While experience may influence efficiency, it is not the primary factor in deciding what can be delegated. A newly trained AP may be competent for certain tasks, while years of experience do not guarantee suitability for all delegated care.

D. The client's age: Age alone does not dictate whether a task can be delegated. Delegation decisions depend more on the client's acuity, stability, and the complexity of care required, rather than demographic factors like age.

A. Report of menstrual cycle B. Weight change C. Skin condition D. Neck exam E. Laboratory results F. Eye appearance

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"A"},"F":{"answers":"A"}}

Explanation

Rationale:

• Report of menstrual cycle: The client’s last menstrual period was 3 months ago, indicating amenorrhea. This is commonly seen in hyperthyroidism due to hormonal imbalances that interfere with normal menstrual regulation.

• Weight change: She reports a 3-month history of unintentional weight loss with a good appetite, which reflects the increased metabolic rate typically caused by elevated thyroid hormone levels in hyperthyroidism.

• Skin condition: Her skin is described as warm and moist, which is consistent with hyperthyroidism. Excess thyroid hormone increases heat production and stimulates the sweat glands.

• Neck exam: The presence of a visible goiter suggests thyroid gland enlargement, often due to overstimulation by thyroid-stimulating immunoglobulins in autoimmune hyperthyroidism like Graves' disease. A goiter can occur in Hypothyroidism (e.g., Hashimoto's thyroiditis) as the gland tries to compensate. Therefore, this finding is consistent with both.

• Laboratory results: Elevated T3 (230 ng/dL), free T4 (3.4 ng/dL), and TSI (150%) confirm hyperthyroidism. These values exceed the normal range and strongly indicate an overactive thyroid gland.

• Eye appearance: Exophthalmos (protruding eyes) is observed, a hallmark of Graves’ disease. This autoimmune feature is linked exclusively to hyperthyroidism and is caused by inflammation and tissue buildup behind the eyes.

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A nurse at an outpatient mental health facility is monitoring effective use of stress management techniques for a client who is attending stress management group therapy. Which of the following statements made by the client indicates effective use of cognitive reframing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to delegate client care to an assistive personnel (AP). Which of the following information should the nurse verify prior to delegation?

Correct Answer is B

Explanation

A nurse is assisting with the care of a client in a provider's clinic. Exhibits For each finding of the client, click to specify if the finding is consistent with Hyperthyroidism or Hypothyroidism. Each finding may support more than one disease process.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"A"},"F":{"answers":"A"}}

Explanation

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