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 A

Explanation

Rationale:

A. Ensure the client swallows each dose of medication: Clients with recent suicide attempts are at risk for hoarding medications to use in a future overdose. The nurse should closely monitor medication administration and confirm that each dose is swallowed to ensure safety.

B. Limit the personal toiletries in the client's room to cologne: Cologne often contains alcohol and could be misused for ingestion or fire-related self-harm. It should not be permitted. All personal items should be carefully screened to eliminate potential hazards.

C. Observe the client's behavior every 2 hr: Monitoring every 2 hours is insufficient for a client at high risk of suicide. More frequent or continuous observation (such as 1:1 supervision) is typically warranted during the acute phase to ensure immediate safety.

D. Keep the client's door shut when they are in the room: Keeping the door closed limits visibility and increases the risk of the client engaging in self-harm without detection. The door should remain open or observation should be maintained to ensure the client’s ongoing safety.

A. Decreased heart rate B. Sudden weight loss C. Increased urinary output D. White patches on the tongue

Correct Answer is A

Explanation

Rationale:

A. Decreased heart rate: Propranolol is a non-selective beta-blocker that reduces heart rate by blocking beta-1 receptors in the heart. Bradycardia is a common and expected adverse effect, and clients should be taught to monitor their pulse regularly and report significant drops.

B. Sudden weight loss: Sudden weight loss is not a typical adverse effect of propranolol. If it occurs, it may indicate an underlying condition or adverse reaction unrelated to the pharmacologic action of beta-blockers and should be evaluated separately.

C. Increased urinary output: Propranolol does not act on the kidneys to promote diuresis. While beta-blockers may be used in combination with diuretics, increased urine output is not a direct effect of this medication and is not expected.

D. White patches on the tongue: White patches on the tongue suggest oral candidiasis, which is more commonly associated with inhaled corticosteroids, not beta-blockers like propranolol. This symptom is unrelated to the medication’s mechanism of action.

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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 planning care for a client who recently attempted suicide. Which of the following actions should the nurse plan to take?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who has a new prescription for propranolol. The nurse should include which of the following as a potential adverse effect of this medication?

Correct Answer is A

Explanation

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