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 C

Explanation

Rationale:

A. Projectile vomiting: Projectile vomiting is more commonly associated with pyloric stenosis in infants, not intussusception. While vomiting may occur in intussusception, it is typically bilious and not forceful or projectile in nature.

B. Periorbital edema: Periorbital edema is typically related to renal or allergic conditions such as nephrotic syndrome or severe allergic reactions. It is not associated with gastrointestinal issues like intussusception.

C. Stools that contain currant jelly-like mucus: Intussusception causes bowel telescoping, leading to obstruction and compromised blood flow. This results in stools containing blood and mucus, often described as “currant jelly,” which is a hallmark symptom of the condition.

D. Visible gastric peristaltic waves: Visible peristalsis is more indicative of pyloric stenosis, where there is hypertrophy of the pyloric muscle. It is not typically seen in cases of intussusception.

A. "You should appoint a family member as your health care surrogate." B. "Once you have completed a living will, it cannot be changed." C. "You will need an attorney to appoint a health care surrogate." D. "Your health care surrogate will make decisions on your behalf if you are unable."

Correct Answer is D

Explanation

Rationale:

A. "You should appoint a family member as your health care surrogate.": While clients may choose a family member, they are not required to do so. The decision is personal, and clients can appoint anyone they trust, regardless of relation, to serve as their health care surrogate.

B. "Once you have completed a living will, it cannot be changed.": A living will can be revised or revoked at any time by the client as long as they remain mentally competent. Clients retain the right to alter their advance directives based on changes in preferences or health status.

C. "You will need an attorney to appoint a health care surrogate.": Appointing a health care surrogate does not require an attorney. Most states allow individuals to complete this process using standardized forms and witnesses, without the need for legal representation.

D. "Your health care surrogate will make decisions on your behalf if you are unable.": A health care surrogate is authorized to make medical decisions when the client is no longer capable of doing so. This ensures that the client’s preferences are respected even if they become incapacitated.

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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?

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